Application of Commando and Hemi-Commando procedures in the reconstruction of intervalvular fibrous body
Objective To analyze the short-and mid-term outcomes of patients undergoing reconstruction of intervalvular fibrous body(IVFB)via double valve replacement(Commando procedure)or aortic valve replacement and mitral valve repair(Hemi-Commando procedure).Methods The patients who underwent Commando or Hemi-Commando procedure between September 2014 and September 2022 in Guangdong Provincial People's Hospital were collected.The perioperative and follow-up data were reviewed and analyzed for the assessment of short-and mid-term outcomes.Results Eleven patients received Commando procedure(a Commando group),including 4 males and 7 females with a median age of 61(33,68)years;7 patients received Hemi-Commando procedure(a Hemi-Commando group),including 5 males and 2 females with a median age of 50(36,58)years.Two patients died in the postoperative 30 days(1 patient in the Commando group and 2 patients in the Hemi-commando group).Low cardiac output syndrome complicated with multiple organ dysfunction syndrome was the main cause of death.Fifteen patients were discharged and followed up for 13(6,42)months,with a survival rate of 100％.The rates of free from recurrent endocarditis or re-operation were both 100％.Conclusion Commando and Hemi-Commando procedures are effective strategies for IVFB reconstruction,and can achieve excellent mid-term outcomes if patients survive from the frailest period of early postoperative stage.
Commando procedureHemi-Commando procedureintervalvular fibrous body reconstructioninvasive endocarditis
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