Surgical Aortic Mitral Curtain Replacement: Systematic Review and Metanalysis of Early and Long-Term Results

Ilaria Giambuzzi*, Giorgia Bonalumi, Michele Di Mauro, Maurizio Roberto, Silvia Corona, Francesco Alamanni, Marco Zanobini

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

Abstract

The Commando procedure is challenging, and aims to replace the mitral valve, the aortic valve and the aortic mitral curtain, when the latter is severely affected by pathological processes (such as infective endocarditis or massive calcification). Given the high complexity, it is seldomly performed. We aim to review the literature on early (hospitalization and up to 30 days) and long-term (at least 3 years of follow-up) results. Bibliographical research was performed on PubMed and Cochrane with a dedicated string. Papers regarding double valve replacement or repair in the context of aortic mitral curtain disease were included. The metaprop function was used to assess early survival and complications (pacemaker implantation, stroke and bleeding). Nine papers (540 patients, median follow-up 41 (IQR 24.5-51.5) months) were included in the study. Pooled proportion of early mortality, stroke, pacemaker implant and REDO for bleeding were, respectively 16.2%, 7.8%, 25.1% and 13.1%. The long-term survival rate ranged from 50% to 92.2%. Freedom from re-intervention was as high as 90.9% when the endocarditis was not the first etiology and 78.6% in case of valvular infection (one author had 100%). Freedom from IE recurrences reached 85% at 10 years. Despite the high mortality, the rates of re-intervention and infective endocarditis recurrences following the Commando procedure are satisfactory and confirm the need for an aggressive strategy to improve long-term outcomes.

Original languageEnglish
Article number3163
Number of pages11
JournalJournal of Clinical Medicine
Volume10
Issue number14
DOIs
Publication statusPublished - Jul 2021

Keywords

  • endocarditis
  • aortic mitral curtain
  • Commando procedure
  • UFO procedure
  • INTERVALVULAR FIBROUS BODY
  • INFECTIVE ENDOCARDITIS
  • VALVE-REPLACEMENT
  • RECONSTRUCTION
  • METAANALYSIS
  • EPIDEMIOLOGY
  • HOMOGRAFT
  • OUTCOMES
  • SURGERY
  • ROOT

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