In this article, the authors present their single center outcomes of the Commando procedure as a means to achieve double valve replacement in patients with radiation heart disease or previous valve replacement with destroyed intervalvular fibrosa. The authors looked to compare early and intermediate-term outcomes of the Commando procedure performed for noninfective pathologies against outcomes of patients undergoing double valve replacement. A total of 129 Commando procedures were performed at the Cleveland Clinic between 2011 and 2022, compared to 1,191 stand double valve replacement. Their findings showed comparable short-term outcomes, but intermediate-term survival was less favorable after the Commando procedure.