scholarly journals Ebstein's Anomaly of the Tricuspid Valve: The Cone Repair

Author(s):  
Jose Pedro da Silva ◽  
Luciana da Fonseca da Silva
2021 ◽  

We present a 52-year-old woman with Ebstein’s anomaly not previously treated. In this subset of patients, there are no clear guidelines regarding the best surgical strategy for treating the tricuspid valve: replace it or repair it. In this case, extensive repair of the tricuspid valve and the right ventricle is achieved using the cone repair technique popularized by Dr. José Pedro Da Silva. Because the patient also presented with symptomatic paroxysmal atrial fibrillation, a right atrial maze procedure combined with isolation of the pulmonary veins was performed using both radiofrequency and cryotherapy. At the last follow-up, 2 years after the repair, the patient is asymptomatic and maintains sinus rhythm. The last echocardiogram showed mild tricuspid regurgitation with normal right ventricular function.


2020 ◽  
Author(s):  
Eun-Young Choi ◽  
Eun Sun Kim ◽  
Jung Yoon Kim ◽  
Seong-Ho Kim ◽  
Jae Hong Lim ◽  
...  

Abstract Background: Ebstein’s anomaly exhibits a wide variety of clinical features, and therefore, proposing a standardized treatment for it is difficult. This study was conducted to determine whether Cone repair, which has been implemented in our hospital since 2008, is more effective than conventional repair.Methods: We retrospectively analyzed the clinical information of patients with Ebstein’s anomaly who were followed-up at the hospital from 2000 to 2019. A total of 61 patients who had undergone tricuspid valve repair after 2000 were divided into the conventional and Cone repair groups and their clinical outcomes were compared.Results: Of the 170 patients, 82 (48.2%) patients received surgical treatment for the tricuspid valve, whereas 75 patients received only medical treatment. The median follow-up duration was 5.89 years. After surgery, tricuspid valve regurgitation decreased and aortic stroke volume increased in both the Cone and conventional repair groups. In the Cone repair group, no mortality and postoperative complete atrioventricular block occurred and significantly fewer cases of moderate to severe tricuspid valve regurgitation were noted after surgery compared with the conventional repair group.Conclusions: Cone repair is thought to be a method with less mortality and less occurrence of complete atrioventricular block than conventional repair.


1970 ◽  
Vol 1 (1) ◽  
pp. 112-114
Author(s):  
SAMA Sabur ◽  
Z Rashid ◽  
A Fazel ◽  
MMG Chowdhury ◽  
M Zaman ◽  
...  

Ebstein’s anomaly is a rare form of congenital heart disease with incidence of 1% of all congenital heart diseases. There are two modes of surgical correction of Ebstein’s anomaly: either biventricular repair with or without tricuspid valve replacement, or palliative univentricular repair consisting of bidirectional Glenn shunt or Fontan procedure. We treated a case of severe form of Ebstein’s anomaly with ASD secundum with WPW syndrome. Radiofrequency ablation was done to treat WPW syndrome preoperatively. Celermajer’s index is a prognostic indicator for tricuspid valve repair or replacement. On 04.03.08 tricuspid valve was replaced with 31 mm Carpentier-Edwards bovine pericardial valve under cardiopulmonary bypass. Postoperative period was uneventful. Follow up echo done on 01.06.08 which revealed normally functioning tissue valve found in tricuspid position TR Grade I. So, in conclusion, preoperative evaluation and workout of Celermajer’s index is essential before surgical intervention for decision of tricuspid valve repair or replacement. Last but not the least, any event of arrhythmia should be properly evaluated.Key words: Ebstein’s anomaly, WPW (Wolff- Parkinson-White) Syndrome, Celermajer’s index, Tissue valve. DOI: http://dx.doi.org/10.3329/cardio.v1i1.8213 Cardiovasc. j. 2008; 1(1) : 112-114  


Author(s):  
Junya Nabeshima ◽  
Masaaki Yamagishi ◽  
Yoshinobu Maeda ◽  
Hisayuki Hongu ◽  
Hiroki Nakatsuji ◽  
...  

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