Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Apr 13;16(1):79.
doi: 10.1186/s13019-021-01480-4.

Modified commando procedure in complicated infective endocarditis ─ a case series

Posung Chen  1   2 , Chungyi Chang  3 , Yicheng Chuang  3 , Ichen Chen  3 , Tingchao Lin  4   5
Affiliations
Case Reports

Modified commando procedure in complicated infective endocarditis ─ a case series

Posung Chen et al. J Cardiothorac Surg. .

Abstract

Background: Complicated infective endocarditis (IE) with perivalvular abscess and destruction of intervalvular fibrous body (IFB) has high mortality risk and requires emergent or urgent surgery mostly.

Case presentation: We presented four patients with complicated infective endocarditis combined with perivalvular abscess and IFB destruction. Three patients had prosthetic valve endocarditis and one patient had native valve endocarditis. They all received modified Commando procedure successfully. No surgical mortality or re-exploration for bleeding.

Conclusions: We suggest that modified Commando procedure may have some benefit in improving survival rate of patients with complicated IE and reducing complications.

Keywords: Infective endocarditis; Intervalvular fibrous body; Prosthetic valve endocarditis; Surgical reconstruction; Valvular heart disease.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
a Extend the aortotomy from the noncoronary cusp into the IFB and onto the left atrial roof. b Post removal of infective tissue (aortic valve, mitral valve, partial aortic annulus and IFB). c Bovine pericardium (two triangular shape) for reconstruction of IFB, interatrial septum and aortic root. d Post IFB reconstruction. Suture for valve replacement. e Post AVR and MVR. f Reconstruction of interatrial septum and aortic root, then proceed to reconstruction of left atrial roof and right atrium
Fig. 2
Fig. 2
a Patient 1, aortic valve perforation: non-coronary-cusp & left-coronary-cusp. b Patient 1, mitral valve post annuloplasty with vegetable formation and perforation. c Patient 1, post removal of mitral valve and annuloplasty ring. d Patient 2, dehiscence of mitral prosthetic valve. e Patient 3, vegetations over aortic perivalvular area and IFB perforation. f Patient 3, post modified Commando procedure and aortic root reconstruction with Cabrol method
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. David TE, Kuo J, Armstrong S. Aortic and mitral valve replacement with reconstruction of the intervalvular fibrous body. J Thorac Cardiovasc Surg. 1997;114(5):766–771. doi: 10.1016/S0022-5223(97)70080-1. - DOI - PubMed
    1. Davierwala PM, Binner C, Subramanian S, Luehr M, Pfannmueller B, Etz C, Dohmen P, Misfeld M, Borger MA, Mohr FW. Double valve replacement and reconstruction of the intervalvular fibrous body in patients with active infective endocarditis. Eur J Cardiothorac Surg. 2014;45(1):146–152. doi: 10.1093/ejcts/ezt226. - DOI - PubMed
    1. Forteza A, Centeno J, Ospina V, Lunar IG, Sánchez V, Pérez E, López MJ, Cortina J. Outcomes in aortic and mitral valve replacement with intervalvular fibrous body reconstruction. Ann Thorac Surg. 2015;99(3):838–845. doi: 10.1016/j.athoracsur.2014.09.052. - DOI - PubMed
    1. Nakamura K, Hashimoto K, Sakamoto Y, Bando K, Yoshitake M, Matsumura Y, Kinouchi K, Abe T. Safe use of Glutaraldehyde to repair the destroyed valve in active infective mitral valve endocarditis. Circ J. 2018;82(10):2530–2534. doi: 10.1253/circj.CJ-17-1433. - DOI - PubMed
    1. Sabik JF, Lytle BW, Blackstone EH, Marullo AGM, Pettersson GB, Cosgrove DM. Aortic root replacement with cryopreserved allograft for prosthetic valve endocarditis. Ann Thorac Surg. 2002;74(3):650–659. doi: 10.1016/S0003-4975(02)03779-7. - DOI - PubMed

Publication types

MeSH terms