Re-do Commando procedure with bioprosthetic mitral valve and aortic homograft for mitral valve dehiscence from prior Commando procedure

The Commando procedure, aortic and mitral valve replacement with aortomitral junction reconstruction, first described by Tirone David in 1997, is indicated in infective endocarditis with abscess, severe mitral annular calcification, lack of annular tissue to sew to in the setting of reoperation, and to prevent patient-prosthesis mismatch. Here we report a true re-do Commando procedure for mitral valve dehiscence using a bioprosthetic mitral valve and aortic homograft.