ArticleInterdisciplinary cardiovascular and thoracic surgery2026
The "Commando" Procedure in Colombia: Early and Mid-Term Outcomes From the Largest Latin American Series.
Article in Interdisciplinary cardiovascular and thoracic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesReconstruction of the mitro-aortic fibrous, or "Commando," procedure has emerged as a radical but effective alternative in patients previously considered "inoperable." However, the low incidence of cases limits the procedures application and data. This study sought to evaluate early and mid-term outcomes in patients undergoing the "Commando" procedure at an institution in Colombia.
methodsWe conducted a single-institution, retrospective analysis of clinical, perioperative, and follow-up outcomes in patients who underwent the Commando procedure at a tertiary referral centre in northeastern Colombia between July 2018 and June 2025. Patients were categorized into endocarditis and non-endocarditis groups.
resultsA total of 37 patients were included, with endocarditis as the most frequent cause in 29 cases (78.4%). The median age was 54 years (IQR 43-68), comparable between groups. Prior cardiac surgery was higher in the non-endocarditis group (100% vs 58.6%, P = .036). Operative mortality was 13.5%, all of them in the endocarditis group. Kaplan-Meier estimated overall survival after the Commando procedure was 80.3% at 1 year (95% CI, 63.0-90.1) and 59.2% at both 3 and 5 years. One-year survival was 78.5% (95% CI, 58.1-89.8%) in the endocarditis group vs 87.50% (95% CI, 38.7-98.1%) in the non-endocarditis group.
conclusionsThe Commando procedure can be performed safely in middle-income settings, with outcomes comparable to high-volume centres in developed countries. This study represents the largest Latin American series to date, showing that prognosis is driven more by disease severity than by socioeconomic context.
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