Commando procedure in cardiac surgery: a narrative review.

Objective: The Commando procedure is a technically demanding, high-risk cardiac operation. This review synthesizes advancements in the Commando procedure, with emphasis on technical modifications, broadening clinical applications, and associated clinical outcomes.

Methods: The study employed a systematic literature search in PubMed, utilizing the term "Commando Procedure," covering all publication dates, yielding 178 identified articles. The inclusion criteria favored peer-reviewed studies that offered detailed surgical accounts, case series with a minimum of five patients, outcome evaluations, or technical innovations-e.g., novel patching or suture techniques. The editorials and studies devoid of procedural details or quantitative results were excluded. Editorials and studies devoid of procedural details or quantitative results were excluded.

Results: The review details the expanded clinical applications, technical improvements, and outcome trends of the Commando procedure. Initially crafted to manage aortic annular dilation, the technique now covers a broader spectrum of complex multivalvular diseases. The correlation between recent procedural standardization and broader clinical adoption is evident in improved survival rates. However, unresolved challenges remain. However, unresolved challenges remain.

Conclusion: In recent years, we have witnessed a proliferation of procedural modifications and adaptations of the Commando technique, tailored to address anatomically distinct pathologies across heterogeneous clinical scenarios.