Kinami Hiroo, Kalfa David M, Goldstone Andrew B, Setton Mattan I, Ferris Anne Marie, Bacha Emile A
Department of Cardiac Surgery, Morgan Stanley Children's Hospital, Columbia University Irving Medical Center, New York, NY.
Department of Pediatric Cardiology, Morgan Stanley Children's Hospital, Columbia University Irving Medical Center, New York, NY.
JTCVS Tech. 2023 Mar 22;19:104-108. doi: 10.1016/j.xjtc.2023.03.008. eCollection 2023 Jun.
The Commando procedure involves division of the intervalvular fibrous body, mitral valve replacement, and aortic valve replacement. It is considered a technically challenging procedure and traditionally has had high mortality.
Five pediatric patients with combined left ventricular inflow and outflow obstruction were included in this study.
There were no early or late deaths during follow-up, and no pacemakers were implanted. None of the patients required reoperation during follow-up, and none developed a clinically significant gradient across the mitral valve or aortic valve.
The risks of this operation for patients with congenital heart disease undergoing multiple redo operations should be weighed against the benefits of normal-size mitral and aortic annular diameters and dramatically improved hemodynamics.
“突击手术”包括室间纤维体离断、二尖瓣置换和主动脉瓣置换。该手术在技术上被认为具有挑战性，传统上死亡率较高。
本研究纳入了5例合并左心室流入道和流出道梗阻的儿科患者。
随访期间无早期或晚期死亡病例，未植入起搏器。随访期间无患者需要再次手术，且无一例患者在二尖瓣或主动脉瓣上出现具有临床意义的压力阶差。
对于接受多次再次手术的先天性心脏病患者，应权衡该手术的风险与二尖瓣和主动脉瓣环直径正常以及血流动力学显著改善的益处。
