Left ventricular outflow tract to left atrial fistula: A rare long-term complication of the commando procedure

Echocardiography. 2022 Jan;39(1):140-145. doi: 10.1111/echo.15279. Epub 2021 Dec 18.

Abstract

The commando procedure involves aortic and mitral valve replacement with complete reconstruction of the aorto-mitral curtain. It is often a surgical treatment for invasive infective endocarditis with abscess, or less commonly for radiation-induced heart disease with extensive calcification extending from the aortic valve onto the anterior mitral leaflet. Prosthetic valve endocarditis is a known long-term complication of this surgery; however, reports of other long-term outcomes are limited. We report the case of a 59-year-old male who developed a non-infectious left ventricular outflow tract to left atrial fistula, incidentally found 5 years after undergoing a commando procedure for radiation-induced heart disease.

Keywords: commando procedure; fistula; transesophageal echocardiography.

Publication types

  • Case Reports

MeSH terms

  • Aortic Valve / surgery
  • Endocarditis, Bacterial* / complications
  • Fistula* / diagnostic imaging
  • Fistula* / etiology
  • Fistula* / surgery
  • Heart Valve Prosthesis Implantation* / adverse effects
  • Heart Valve Prosthesis*
  • Humans
  • Male
  • Middle Aged
  • Mitral Valve / surgery