Doctors at KIMS Hospitals, Thane, successfully performed the rare and highly complex Commando procedure on a 52-year-old woman suffering from multiple life-threatening heart conditions, helping her regain her quality of life.
The patient had undergone a mitral valve replacement in 2020. However, she later developed severe breathlessness that began affecting her daily activities. After consulting Dr. B.C. Kalmath, Director of Cardiac Sciences at KIMS Hospitals, detailed investigations revealed severe narrowing of the artificial mitral valve, a large clot in the left atrium, a diseased aortic valve, tricuspid valve leakage, severe pulmonary hypertension, and an extremely small aortic root. Doctors therefore recommended a complex redo heart surgery.
Surgeons Opt for Rare Commando Procedure
“This was an exceptionally high-risk case because multiple cardiac problems had developed simultaneously. Careful planning, multidisciplinary expertise, and timely intervention were critical to achieving a successful outcome,” said Dr. B.C. Kalmath.
The surgery was led by Dr. Saumya Sekhar, Consultant Cardiothoracic & Vascular Surgeon, along with Dr. Leena Tayshete, Cardiac Anaesthetist.
As per the press release, surgeons initially planned a conventional redo valve replacement. However, after reopening the chest, they found that the patient’s complex heart anatomy required the Commando procedure, one of the most technically demanding operations in cardiac surgery.
The surgical team reconstructed the heart’s central fibrous structure before replacing the diseased mitral and aortic valves with mechanical prosthetic valves. They also repaired the leaking tricuspid valve during the same operation.
“We were not just replacing damaged valves. We had to reconstruct the heart’s central supporting framework before safely implanting the new valves,” said Dr. Saumya Sekhar.
Patient Recovers Well After Surgery
The patient’s heart returned to a normal rhythm after blood flow was restored, and doctors weaned her off the heart-lung machine with minimal medication support. She was taken off the ventilator on the first day after surgery, began walking on the fourth day, and was discharged on the eighth day. A follow-up echocardiogram confirmed that both replacement valves were functioning well.
The successful outcome highlights how advanced reconstructive cardiac surgery can effectively treat patients with complex valve disease, even in high-risk redo heart surgeries.