Reconstruction of fibrous skeleton: technique, pitfalls and results

Destruction of the intervalvular fibrosa (IVF) in infective endocarditis makes radical debridement followed by reconstruction of the IVF as the best treatment available for these patients. Authors describe their techniques in dealing with these extremely challenging cases, and show their results. At Cleveland Clinic, operations requiring reconstruction of the IVF are referred to as ‘Commando operations’, an indicator of the procedure's challenges.