The Commando procedure for mechanical double valve prosthesis endocarditis with destruction of the aortomitral continuity.

Sami Mouritane, Birgit Zirngast, Melanie Arnreiter, Günther Laufer, Daniel Zimpfer
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Abstract

Infective endocarditis, particularly after implanting valve prostheses, poses significant surgical challenges, often requiring complex interventions. We describe a case of a 37-year-old male with Staphylococcus aureus endocarditis, unsuccessfully treated with mechanical valve prostheses. Continued infection led to the destruction of the intervalvular fibrous body, necessitating a Commando procedure involving radical debridement and replacement of both aortic and mitral valves with complex patch reconstruction. Prosthesis selection remains contentious, considering recurrence risk and long-term prognosis. Our case underscores timely intervention and meticulous technique in managing such complex situations. It highlights successful strategies for treating infective endocarditis with destruction of aortomitral continuity, emphasizing the pivotal role of the Commando procedure.

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突击队手术治疗伴有主动脉连续性破坏的机械双瓣人工心内膜炎。
感染性心内膜炎,尤其是植入人工瓣膜后的感染性心内膜炎,给外科手术带来了巨大挑战,往往需要复杂的干预措施。我们描述了一例患有金黄色葡萄球菌心内膜炎的 37 岁男性病例,该患者使用机械瓣膜修复术治疗未果。持续感染导致瓣间纤维体被破坏,因此必须进行突击队手术,包括根治性清创、主动脉瓣和二尖瓣置换以及复杂的补片重建。考虑到复发风险和长期预后,假体的选择仍然存在争议。我们的病例强调了在处理此类复杂情况时的及时干预和细致技术。该病例强调了治疗主动脉-二尖瓣连续性破坏的感染性心内膜炎的成功策略,强调了突击队手术的关键作用。
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CiteScore
0.60
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0.00%
发文量
60
期刊介绍: The Multimedia Manual of Cardio-Thoracic Surgery (MMCTS) is produced by The European Association for Cardio-Thoracic Surgery (EACTS). MMCTS is the world’s premier video-based educational resource for cardiovascular and thoracic surgeons; freely accessible - and essential - for all. MMCTS was launched more than ten years ago under the leadership of founding editor Professor Marko Turina. It was Professor Turina’s vision that the European Association for Cardio-Thoracic Surgery (EACTS), already the world-leader in CT surgery education, should take advantage of the Internet’s rapidly improving video publication capabilities and create a new step-by-step manual of surgical procedures. Professor Turina and EACTS agreed that the manual, MMCTS, should be freely accessible to all users, regardless of association membership status, nationality, or affiliation. MMCTS was self-published by EACTS for some years before being transferred to Oxford University Press, which hosted it until the end of 2016. In November 2016, the Manual returned home to EACTS and it has now relaunched in a completely new format. Since its birth in 2005, MMCTS has published some 400 detailed, video-based demonstrations of cardio-thoracic surgical procedures. Tutorials published prior to 2012 have been archived and we are working with the authors of these tutorials to update their work pending republication on the new site. Our mission is to make MMCTS the best online reference for cardio-thoracic surgeons – residents and experienced surgeons alike. Our aim is to include tutorials presenting procedures at both a fundamental and an advanced level. Truly innovative procedures are also included and are identified as such.
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