{"id":"https://openalex.org/W7204129112","doi":"https://doi.org/10.66636/gmj.v1.i3.a198","title":"Successful combined aortic and mitral valve replacement with biological prostheses using the COMMANDO procedure under conditions of narrow valve rings and severe calcification via a mini-sternotomy approach: a case report","display_name":"Successful combined aortic and mitral valve replacement with biological prostheses using the COMMANDO procedure under conditions of narrow valve rings and severe calcification via a mini-sternotomy approach: a case report","publication_year":2026,"publication_date":"2026-08-24","ids":{"openalex":"https://openalex.org/W7204129112","doi":"https://doi.org/10.66636/gmj.v1.i3.a198"},"language":"en","primary_location":{"id":"doi:10.66636/gmj.v1.i3.a198","doi":"https://doi.org/10.66636/gmj.v1.i3.a198","is_oa":true,"landing_page_url":"https://doi.org/10.66636/gmj.v1.i3.a198","pdf_url":"https://gmj.ge/index.php/pub/article/download/198/137","source":{"id":"https://openalex.org/S7407057816","display_name":"Georgian Medical Journal","issn_l":"3088-4322","issn":["3088-4322"],"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Georgian Medical Journal","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"hybrid","oa_url":"https://gmj.ge/index.php/pub/article/download/198/137","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5122819718","display_name":"GIORGI GABAIDZE","orcid":"https://orcid.org/0009-0001-6209-6613","observed_orcids":["https://orcid.org/0009-0001-6209-6613"]},"institutions":[{"id":"https://openalex.org/I4405256619","display_name":"Avicenna - Batumi Medical University","ror":"https://ror.org/04c34mc83","country_code":"GE","type":"education","lineage":["https://openalex.org/I4405256619"]},{"id":"https://openalex.org/I4405279158","display_name":"New Vision University","ror":"https://ror.org/0135qjt26","country_code":"GE","type":"education","lineage":["https://openalex.org/I4405279158"]}],"countries":["GE"],"is_corresponding":false,"raw_author_name":"Giorgi Gabaidze","raw_affiliation_strings":["Department of Cardiac Surgery, Medcenter, Batumi, Georgia; New Vision University, Tbilisi, Georgia; Avicenna-Batumi Medical University, Batumi, Georgia"],"raw_orcid":"https://orcid.org/0009-0001-6209-6613","affiliations":[{"raw_affiliation_string":"Department of Cardiac Surgery, Medcenter, Batumi, Georgia; New Vision University, Tbilisi, Georgia; Avicenna-Batumi Medical University, Batumi, Georgia","institution_ids":["https://openalex.org/I4405256619","https://openalex.org/I4405279158"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5057045442","display_name":"B.R. Nachkebiya","orcid":"https://orcid.org/0000-0003-0863-043X","observed_orcids":["https://orcid.org/0000-0003-0863-043X"]},"institutions":[{"id":"https://openalex.org/I4405256619","display_name":"Avicenna - Batumi Medical University","ror":"https://ror.org/04c34mc83","country_code":"GE","type":"education","lineage":["https://openalex.org/I4405256619"]}],"countries":["GE"],"is_corresponding":false,"raw_author_name":"Bachuki Nachkebia","raw_affiliation_strings":["Department of Cardiac Surgery, Medcenter, Batumi, Georgia; Avicenna-Batumi Medical University, Batumi, Georgia"],"raw_orcid":"https://orcid.org/0000-0003-0863-043X","affiliations":[{"raw_affiliation_string":"Department of Cardiac Surgery, Medcenter, Batumi, Georgia; Avicenna-Batumi Medical University, Batumi, Georgia","institution_ids":["https://openalex.org/I4405256619"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5066557421","display_name":"Giorgi Pkhakadze","orcid":"https://orcid.org/0000-0001-7609-4515","observed_orcids":["https://orcid.org/0000-0001-7609-4515"]},"institutions":[{"id":"https://openalex.org/I4405256619","display_name":"Avicenna - Batumi Medical University","ror":"https://ror.org/04c34mc83","country_code":"GE","type":"education","lineage":["https://openalex.org/I4405256619"]}],"countries":["GE"],"is_corresponding":false,"raw_author_name":"Medea Kadjaia","raw_affiliation_strings":["Department of Intensive Care, Medcenter, Batumi, Georgia; Avicenna-Batumi Medical University, Batumi, Georgia"],"raw_orcid":"https://orcid.org/0000-0001-7609-4515","affiliations":[{"raw_affiliation_string":"Department of Intensive Care, Medcenter, Batumi, Georgia; Avicenna-Batumi Medical University, Batumi, Georgia","institution_ids":["https://openalex.org/I4405256619"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5147916329","display_name":"Giorgi Giorgadze","orcid":"https://orcid.org/0009-0006-5174-6832","observed_orcids":["https://orcid.org/0009-0006-5174-6832"]},"institutions":[{"id":"https://openalex.org/I4405256619","display_name":"Avicenna - Batumi Medical University","ror":"https://ror.org/04c34mc83","country_code":"GE","type":"education","lineage":["https://openalex.org/I4405256619"]}],"countries":["GE"],"is_corresponding":false,"raw_author_name":"Giorgi Giorgadze","raw_affiliation_strings":["Department of Cardiac Surgery, Medcenter, Batumi, Georgia; Avicenna-Batumi Medical University, Batumi, Georgia"],"raw_orcid":"https://orcid.org/0009-0006-5174-6832","affiliations":[{"raw_affiliation_string":"Department of Cardiac Surgery, Medcenter, Batumi, Georgia; Avicenna-Batumi Medical University, Batumi, Georgia","institution_ids":["https://openalex.org/I4405256619"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5147961176","display_name":"Giga Khozrevanidze","orcid":"https://orcid.org/0009-0008-3908-4148","observed_orcids":["https://orcid.org/0009-0008-3908-4148"]},"institutions":[{"id":"https://openalex.org/I12153360","display_name":"Batumi Shota Rustaveli State University","ror":"https://ror.org/0212gyx73","country_code":"GE","type":"education","lineage":["https://openalex.org/I12153360"]}],"countries":["GE"],"is_corresponding":false,"raw_author_name":"Giga Khozrevanidze","raw_affiliation_strings":["Batumi Shota Rustaveli State University, Batumi, Georgia"],"raw_orcid":"https://orcid.org/0009-0008-3908-4148","affiliations":[{"raw_affiliation_string":"Batumi Shota Rustaveli State University, Batumi, Georgia","institution_ids":["https://openalex.org/I12153360"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5147980019","display_name":"Dimitri Kiria","orcid":"https://orcid.org/0009-0007-4021-0394","observed_orcids":["https://orcid.org/0009-0007-4021-0394"]},"institutions":[{"id":"https://openalex.org/I12153360","display_name":"Batumi Shota Rustaveli State University","ror":"https://ror.org/0212gyx73","country_code":"GE","type":"education","lineage":["https://openalex.org/I12153360"]}],"countries":["GE"],"is_corresponding":false,"raw_author_name":"Dimitri Kiria","raw_affiliation_strings":["Batumi Shota Rustaveli State University, Batumi, Georgia"],"raw_orcid":"https://orcid.org/0009-0007-4021-0394","affiliations":[{"raw_affiliation_string":"Batumi Shota Rustaveli State University, Batumi, Georgia","institution_ids":["https://openalex.org/I12153360"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":3,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"1","issue":"3","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10172","display_name":"Cardiac Valve Diseases and Treatments","score":0.9932000041007996,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10172","display_name":"Cardiac Valve Diseases and Treatments","score":0.9932000041007996,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10618","display_name":"Aortic Disease and Treatment Approaches","score":0.005400000140070915,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11055","display_name":"Cardiac and Coronary Surgery Techniques","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/aortic-stenosis","display_name":"aortic stenosis","score":0.8479999899864197},{"id":"https://openalex.org/keywords/mitral-stenosis","display_name":"mitral stenosis","score":0.9990000128746033},{"id":"https://openalex.org/keywords/commando-procedure","display_name":"Commando procedure","score":0.8090000152587891},{"id":"https://openalex.org/keywords/patient-prosthesis-mismatch","display_name":"prosthesis-patient mismatch","score":0.9449999928474426},{"id":"https://openalex.org/keywords/bioprosthetic-valve-replacement","display_name":"bioprosthetic valve replacement","score":0.8240000009536743},{"id":"https://openalex.org/keywords/ministernotomy","display_name":"ministernotomy","score":0.890999972820282},{"id":"https://openalex.org/keywords/elderly-patients","display_name":"elderly patients","score":0.6320000290870667},{"id":"https://openalex.org/keywords/minimally-invasive-cardiac-surgery","display_name":"minimally invasive cardiac surgery","score":0.7879999876022339}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9142000079154968},{"id":"https://openalex.org/C2780309369","wikidata":"https://www.wikidata.org/wiki/Q933382","display_name":"Calcification","level":2,"score":0.7037000060081482},{"id":"https://openalex.org/C2778881276","wikidata":"https://www.wikidata.org/wiki/Q552304","display_name":"Cardiopulmonary bypass","level":2,"score":0.6736000180244446},{"id":"https://openalex.org/C164705383","wikidata":"https://www.wikidata.org/wiki/Q10379","display_name":"Cardiology","level":1,"score":0.6367999911308289},{"id":"https://openalex.org/C2775854548","wikidata":"https://www.wikidata.org/wiki/Q6882369","display_name":"Mitral valve replacement","level":3,"score":0.618399977684021},{"id":"https://openalex.org/C2777543888","wikidata":"https://www.wikidata.org/wiki/Q369939","display_name":"Mitral valve","level":2,"score":0.5644999742507935},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.5475000143051147},{"id":"https://openalex.org/C2775914520","wikidata":"https://www.wikidata.org/wiki/Q12335414","display_name":"Sinus rhythm","level":3,"score":0.53329998254776},{"id":"https://openalex.org/C2780026749","wikidata":"https://www.wikidata.org/wiki/Q7912830","display_name":"Valve replacement","level":3,"score":0.5230000019073486},{"id":"https://openalex.org/C2778715743","wikidata":"https://www.wikidata.org/wiki/Q181802","display_name":"Prosthesis","level":2,"score":0.49950000643730164},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.489300012588501},{"id":"https://openalex.org/C2780714102","wikidata":"https://www.wikidata.org/wiki/Q616071","display_name":"Aortic valve","level":2,"score":0.43799999356269836},{"id":"https://openalex.org/C178853913","wikidata":"https://www.wikidata.org/wiki/Q1642137","display_name":"Hemodynamics","level":2,"score":0.40720000863075256},{"id":"https://openalex.org/C155710745","wikidata":"https://www.wikidata.org/wiki/Q575278","display_name":"Inotrope","level":2,"score":0.3856000006198883},{"id":"https://openalex.org/C2776570981","wikidata":"https://www.wikidata.org/wiki/Q4413093","display_name":"Aortic valve replacement","level":3,"score":0.38359999656677246},{"id":"https://openalex.org/C2776407911","wikidata":"https://www.wikidata.org/wiki/Q7525187","display_name":"Sinus (botany)","level":3,"score":0.3637000024318695},{"id":"https://openalex.org/C2777385415","wikidata":"https://www.wikidata.org/wiki/Q1615191","display_name":"Cardiac catheterization","level":2,"score":0.3124000132083893},{"id":"https://openalex.org/C80093799","wikidata":"https://www.wikidata.org/wiki/Q366155","display_name":"Intracardiac injection","level":2,"score":0.30640000104904175},{"id":"https://openalex.org/C126838900","wikidata":"https://www.wikidata.org/wiki/Q77604","display_name":"Radiology","level":1,"score":0.28600001335144043},{"id":"https://openalex.org/C2775872228","wikidata":"https://www.wikidata.org/wiki/Q82504","display_name":"Endocarditis","level":2,"score":0.28189998865127563},{"id":"https://openalex.org/C2775981168","wikidata":"https://www.wikidata.org/wiki/Q239027","display_name":"Calcinosis","level":3,"score":0.26989999413490295},{"id":"https://openalex.org/C2778789114","wikidata":"https://www.wikidata.org/wiki/Q235007","display_name":"Cardiac surgery","level":2,"score":0.2549999952316284}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.66636/gmj.v1.i3.a198","doi":"https://doi.org/10.66636/gmj.v1.i3.a198","is_oa":true,"landing_page_url":"https://doi.org/10.66636/gmj.v1.i3.a198","pdf_url":"https://gmj.ge/index.php/pub/article/download/198/137","source":{"id":"https://openalex.org/S7407057816","display_name":"Georgian Medical Journal","issn_l":"3088-4322","issn":["3088-4322"],"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Georgian Medical Journal","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.66636/gmj.v1.i3.a198","doi":"https://doi.org/10.66636/gmj.v1.i3.a198","is_oa":true,"landing_page_url":"https://doi.org/10.66636/gmj.v1.i3.a198","pdf_url":"https://gmj.ge/index.php/pub/article/download/198/137","source":{"id":"https://openalex.org/S7407057816","display_name":"Georgian Medical Journal","issn_l":"3088-4322","issn":["3088-4322"],"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Georgian Medical Journal","raw_type":"journal-article"},"sustainable_development_goals":[{"score":0.9537000060081482,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/case-report","display_name":"Case Report"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7204129112.pdf","grobid_xml":"https://content.openalex.org/works/W7204129112.grobid-xml"},"referenced_works_count":10,"referenced_works":["https://openalex.org/W1964598243","https://openalex.org/W2021384268","https://openalex.org/W2038851398","https://openalex.org/W2059488368","https://openalex.org/W2059606192","https://openalex.org/W2614694672","https://openalex.org/W3003607160","https://openalex.org/W3027241883","https://openalex.org/W3115258265","https://openalex.org/W4220668251"],"related_works":["https://openalex.org/W7118065872","https://openalex.org/W4390619848","https://openalex.org/W7161690559","https://openalex.org/W4411928317","https://openalex.org/W4285606641","https://openalex.org/W4389158354","https://openalex.org/W4401865545","https://openalex.org/W2320213435","https://openalex.org/W2323299471","https://openalex.org/W4391152253"],"abstract_inverted_index":{"Background:":[0],"Simultaneous":[1],"acquired":[2,240],"aortic":[3,94,131,244],"and":[4,12,48,81,95,118,166,213,223,234],"mitral":[5,89,96,181,197,247],"valve":[6,242,245,248],"disease":[7],"complicated":[8],"by":[9],"severe":[10,78,220],"calcification":[11,80,222],"anatomically":[13],"narrow":[14,83,224],"rings":[15],"poses":[16],"a":[17,104,207],"significant":[18],"technical":[19],"challenge":[20],"in":[21,216],"adult":[22],"cardiac":[23,263],"surgery.":[24],"Implantation":[25],"of":[26,44,53,191],"small-sized":[27],"prostheses":[28],"under":[29],"standard":[30],"double-valve":[31],"replacement":[32,98],"risks":[33],"prosthesis-patient":[34,256],"mismatch":[35],"(PPM),":[36],"associated":[37],"with":[38,77,188,219],"elevated":[39],"transprosthetic":[40],"gradients,":[41],"impaired":[42],"regression":[43],"left":[45],"ventricular":[46],"hypertrophy,":[47],"reduced":[49],"long-term":[50],"survival.":[51],"Reconstruction":[52],"the":[54,59,64,100,115],"aorto-mitral":[55,252],"fibrous":[56,253],"continuity":[57,254],"\u2014":[58,62],"COMMANDO":[60,101,203,250],"procedure":[61,204],"is":[63,211],"definitive":[65,189,231],"surgical":[66],"strategy":[67],"to":[68,113],"circumvent":[69],"this":[70],"limitation.":[71],"Case":[72],"presentation:":[73],"A":[74],"73-year-old":[75],"female":[76],"biValvular":[79,221],"critically":[82],"annular":[84,225],"dimensions":[85],"(aortic":[86,177,193],"21":[87],"mm;":[88,130],"34":[90],"mm)":[91],"underwent":[92],"combined":[93],"bioprosthetic":[97],"via":[99],"technique":[102],"through":[103,206],"partial":[105,208],"upper":[106,209],"mini-sternotomy.":[107],"An":[108],"autopericardial":[109],"patch":[110],"was":[111,137,160],"used":[112],"reconstruct":[114],"intervalvular":[116],"fibrosa":[117],"simultaneously":[119],"enlarge":[120],"both":[121],"annuli.":[122],"Hancock":[123],"II":[124],"bioprostheses":[125],"were":[126],"implanted":[127],"(mitral":[128],"29":[129],"25":[132],"mm).":[133],"Cardiopulmonary":[134],"bypass":[135],"time":[136,141],"150":[138],"minutes;":[139,143],"cross-clamp":[140],"135":[142],"intraoperative":[144],"blood":[145],"loss":[146],"200":[147],"mL.":[148],"The":[149,158,202],"heart":[150,241],"resumed":[151],"sinus":[152],"rhythm":[153],"spontaneously":[154],"without":[155],"inotropic":[156],"support.":[157],"patient":[159],"extubated":[161],"on":[162,168],"postoperative":[163],"day":[164,169],"1":[165],"discharged":[167],"9.":[170],"Follow-up":[171],"echocardiography":[172],"confirmed":[173],"excellent":[174,235],"prosthetic":[175],"function":[176],"PGmean":[178,182],"11":[179],"mmHg;":[180,184],"3":[183],"no":[185],"paravalvular":[186],"leak)":[187],"avoidance":[190],"PPM":[192,232],"iEOA":[194,198],"1.85":[195],"cm2/m2;":[196],"2.5":[199],"cm2/m2).":[200],"Conclusion:":[201],"executed":[205],"mini-sternotomy":[210],"safe":[212],"technically":[214],"feasible":[215],"elderly":[217],"patients":[218],"dimensions,":[226],"enabling":[227],"optimal":[228],"prosthesis":[229],"sizing,":[230],"prevention,":[233],"early":[236],"haemodynamic":[237],"outcomes.":[238],"Keywords:":[239],"disease;":[243],"stenosis;":[246,249],"procedure;":[251],"reconstruction;":[255],"mismatch;":[257],"biological":[258],"prosthesis;":[259],"mini-sternotomy;":[260],"minimally":[261],"invasive":[262],"surgery;":[264],"case":[265],"report":[266]},"counts_by_year":[],"updated_date":"2026-10-28T10:33:24.094632","created_date":"2026-08-25T00:00:00"}
