The commando procedure involves aortic and mitral valve replacement with complete reconstruction of the aorto‐mitral curtain. It is often a surgical treatment for invasive infective endocarditis with abscess, or less commonly for radiation‐induced heart disease with extensive calcification extending from the aortic valve onto the anterior mitral leaflet. Prosthetic valve endocarditis is a known long‐term complication of this surgery; however, reports of other long‐term outcomes are limited. We report the case of a 59‐year‐old male who developed a non‐infectious left ventricular outflow tract to left atrial fistula, incidentally found 5 years after undergoing a commando procedure for radiation‐induced heart disease.