The Hemi-Commando Procedure for Endocarditis of the Aortic Root and Aortomitral Fibrosa

For patients with aortic root infective endocardis extending onto the anterior mitral valve leaflet, the Hemi-Commando procedure is an acceptable approach for invasive double-valve IE involving the IVF and only the base of the anterior mitral leaflet. Benefits of the Hemi-Commando operation include preservation of the mitral subvalvular architecture for improved long-term LV function and lower rates of recurrent IE. Invasive double-valve IE requiring IVF reconstruction, while complex and a highly morbid operation, is essential in selected patients to provide cure and warrants further investigation as surgical techniques continue to evolve.