Clinical application of Commando procedure in reoperation for mechanical valve dysfunction
- VernacularTitle:Commando技术在机械瓣瓣膜功能障碍再次置换手术中的临床应用
- Author:
Bo CHEN
1
,
2
;
Ting FAN
1
,
2
;
Yong CAO
1
,
2
;
Guanshui YU
1
,
2
;
Lian HU
1
,
2
;
Ren ZHU
1
,
2
Author Information
1. Department of Cardiovascular Surgery, Gaozhou People'
2. s Hospital, Gaozhou, 525200, Guangdong, P. R. China
- Publication Type:Journal Article
- Keywords:
Commando procedure;
mechanical valve dysfunction;
re-valve replacement
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2024;31(06):838-841
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the feasibility and effectiveness of Commando procedure for mechanical valve dysfunction requiring reoperation. Methods The clinical data of patients who received Commando surgery (aortic/mitral curtain enlargement+valve replacement surgery) in the Department of Cardiovascular Surgery of Gaozhou People's Hospital from December 2021 to September 2022 were retrospectively analyzed. These patients who had undergone mechanical mitral or aortic valve replacement and then had mechanical valve dysfunction with mitral or aortic valve lesions requiring repeat combined valve replacement surgery were selected. Results Eleven patients were enrolled, including 2 males and 9 females, aged 63.63±11.64 years. All 11 patients successfully underwent the Commando operation, and were implanted with suitable artificial valves, among which the aortic valve size was 27.00±2.00 mm, and the mitral valve size was 27.72±3.13 mm. Cardiopulmonary bypass time was 195.81±39.29 min, aortic cross-clamping time was 121.81±28.60 min, mechanical ventilation time was 15.09±3.72 h, ICU stay time was 3.09±0.70 days, and total postoperative thoracic drainage volume was 417.18±68.65 mL. There was no perioperative death. Conclusion Commando procedure is a safe and effective method to perform combined valve operation for mechanical valve dysfunction. A larger artificial valve can be implanted during the procedure to obtain sound hemodynamic effects. In addition, for elderly patients, a suitable type of bioprosthetic valve can be implanted to improve the patient's quality of life. The early surgical effect is satisfactory, and the long-term impact needs further follow-up.
