Ventricularization of the atrialized chamber: A concept of Ebstein's anomaly repair Michael V. Ullmann, MD, Sabine Born, MD, Christian Sebening, MD, Matthias.

Slides:

Advertisements

Similar presentations

Autotransplantation for Threatened Cardiac Rupture After Left Ventricular Repair Hiroaki Hata, MD, PhD, Motomi Shiono, MD, PhD, Mitsuru Iida, MD, PhD,

Advertisements

Novel mechanism of mitral regurgitation after lung transplantation in a patient with scleroderma and pulmonary hypertension Christian A. Bermudez, MD,

Transcatheter Valve Implantation in Mitral Annular Calcification During Open Surgery: Extended Collar Technique Michael Ghosh-Dastidar, MBBS, FRCSCTh,

Norman H Silverman, MD, Doff B McElhinney, MD

Tricuspid Valve Repair for Ebstein's Anomaly

Surgical Strategy Toward Biventricular Repair for Severe Ebstein Anomaly in Neonates and Infancy Shu-Chien Huang, MD, PhD, En-Ting Wu, MD, PhD, Shyh-Jye.

Modified Starnes Procedure in a Neonate With Severe Tricuspid Regurgitation Ashok Muralidaran, MD, Richard W. Kim, MD, Gary S. Kopf, MD, Nicholas P. Pietris,

Application of Papillary Muscle Sling Concept in an Infant as a Biological Bridge to Transplantation Nai-Hsin Chi, MD, Shu-Chien Huang, MD, His-Yu Yu,

Complete Atrioventricular Canal: Comparison of Modified Single-Patch Technique With Two-Patch Technique Carl L. Backer, MD, Robert D. Stewart, MD, Frédérique.

Successful Robot-Assisted Repair of Congenital Mitral Valve Regurgitation Vijayakumar Raju, MD, Harold M. Burkhart, MD, Frank Cetta, MD, Rakesh M. Suri,

Surgically created double orifice repair of tricuspid regurgitation in infants with congenital heart disease Toyoki Fukuda, MD, Ichiro Kashima, MD, Shigeki.

Initial Experience With a Miniaturized Multiplane Transesophageal Probe in Small Infants Undergoing Cardiac Operations Sinai C. Zyblewski, MD, Girish.

Gananjay G. Salve, MCh, Shreepal A. Jain, MD, Bharat V

Which two ventricles cannot be used for a biventricular repair

Dennis M. Mello, MD, John Fahey, MD, Gary S. Kopf, MD

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

Norwood Procedure Combined With the Starnes Procedure

Management of Neonatal Ebstein's Anomaly

Jacques A. M. van Son, MD. (by invitation), Gordon K

Joseph A. Dearani, MD, Sameh M. Said, MD, Harold M

Christopher J. Knott-Craig, MD, Steven P. Goldberg, MD, Edward D

Intra-Atrial Rerouting and Maze Procedure for an Adult Patient in Cor Triatriatum, Persistent Left Superior Vena Cava, and Atrial Fibrillation Koichi.

Cardiac blood-filled cyst at the atrialized portion of the right ventricle in a patient with Ebstein anomaly: A case report Smruti Ranjan Mohanty, MCh,

Concealed Left Ventricle to Right Atrium Fistula Complicating Infective Endocarditis Tatsushi Onzuka, MD, PhD, Shoji Morishige, MD, Yoshiyuki Yamashita,

The cone reconstruction of the tricuspid valve in Ebstein’s anomaly

Ritu Sachdeva, MD, Richard T. Fiser, MD, William R

Tricuspid Valve Closure for Neonatal Ebstein’s Anomaly

Hemoptysis as a rare presentation of cor triatriatum sinister

Double-outlet right ventricle with complete atrioventricular canal

Radiofrequency catheter ablation for drug-refractory paroxysmal atrial fibrillation in a patient with Ebstein’s anomaly Yong-Giun Kim, MD, Shin-Jae Kim,

Echocardiographic Identification of Iatrogenic Injury of the Circumflex Artery During Minimally Invasive Mitral Valve Repair Joerg Ender, MD, Michael.

Jorge Sierra, MD, FETCS, Nadia H. Lahlaïdi, MD, Jan T

Ebstein’s Anomaly Assessed by Real-Time 3-D Echocardiography

Brian A. Bruckner, MD, Limael E

Anatomic correction of the syndrome of prolapsing right coronary aortic cusp, dilatation of the sinus of valsalva, and ventricular septal defect Magdi.

Tricuspid Leaflet Augmentation to Eliminate Residual Regurgitation in Severe Functional Tricuspid Regurgitation Jong Bum Choi, MD, Nan Yeol Kim, MD,

Anatomic repair of Ebstein's anomaly with isolated anterior leaflet downward displacement Qingyu Wu, MD, Guangyu Pan, MD, Hongyin Li, MD, Xiangchen Kong,

Surgical Results in Patients With Pulmonary Atresia-Major Aortopulmonary Collaterals in Association With Total Anomalous Pulmonary Venous Connection

Valve-Sparing Aortic Root Replacement and Neochordal Repair of Complex Aortic Leaflet Pathology for Ruptured Sinus of Valsalva Aneurysm Fistulizing to.

Modified Rastelli procedure for double outlet right ventricle with left-malposition of the great arteries: report of 9 cases Qingyu Wu, MD, Qibin Yu,

Successful Use of Transvenous Atrial and Bifocal Left Ventricular Pacing in Ebstein’s Anomaly After Tricuspid Prosthetic Valve Surgery J. Alberto Lopez,

Aortic Translocation for the Management of Double-Outlet Right Ventricle and Pulmonary Stenosis With Dextrocardia: Technique to Avoid Coronary Insufficiency

Fistulous Pseudoaneurysm Complicating Surgical Accessory Pathway Interruption for Wolff-Parkinson-White Syndrome THOMAS L. SALAZER, M.D., J. MICHAEL.

Tricuspid Valve Repair: How I Teach It

Late Results After Extended Pulmonary Artery Reconstruction in the Arterial Switch Operation Michael V. Ullmann, MD, Matthias Gorenflo, MD, Christian.

Double-Root Translocation for Double-Outlet Right Ventricle With Noncommitted Ventricular Septal Defect or Double-Outlet Right Ventricle With Subpulmonary.

Stuart A. Abel, MD, Thomas A. Stark, MD, Kent H

Repair of congenital tricuspid valve abnormalities with artificial chordae tendineae V.Mohan Reddy, MD, Doff B McElhinney, MD, Michael M Brook, MD, Norman.

Tricuspid Valve Prolapse Diagnosed by Cross-Sectional Echocardiography

Cardiac arrhythmia in patients undergoing surgical repair of Ebstein’s anomaly Sylvain M Chauvaud, MD, Gianluca Brancaccio, MD, Alain F Carpentier, MD,

Successful Neonatal Double Switch in Symptomatic Patients With Congenitally Corrected Transposition of the Great Arteries Victor Bautista-Hernandez,

Successful myocardial volume reduction in a 9-month-old infant

Shirin Lalezari, MD, Edris A. F. Mahtab, PhD, Margot M

Surgical Correction for a Neonate With Ebstein's Anomaly Associated With Tetralogy of Fallot Ling-Yi Wei, MD, Jin-Chung Shih, MD, PhD, En-Ting Wu, MD,

P.Michael McFadden, John L Ochsner The Annals of Thoracic Surgery

Norwood Stage 1 With Surgical Ventricular Reconstruction and Mitral Valve Repair for Neonatal Idiopathic Left Ventricular Dilated Cardiomyopathy Patrick.

Modified Edge-to-Edge Technique for Correction of Congenital Mitral Regurgitation in Infants and Children Gang Zhang, MD, Fusheng Zhang, MD, Mei Zhu,

Isolated tricuspid regurgitation caused by a dilated tricuspid annulus

Hypoplastic Left Heart Syndrome With Anomalous Origin of the Right Coronary Artery Julie Cleuziou, MD, Felix Haas, MD, Christian Schreiber, MD, Hans-Jörg.

Perforation of a Tricuspid Pouch Caused by Infective Endocarditis

Pulmonary Valve Repair for Patients With Acquired Pulmonary Valve Insufficiency Sameh M. Said, MD, Richard D. Mainwaring, MD, Michael Ma, MD, Theresa.

Mechanical left ventricular unloading to prevent recurrent myocardial rupture Stephen Westaby, MS, PhD, Vipin Mehta, MD, Fidelma Flynn, MD, Neil Wilson,

Shaun P. Setty, MD, John L. Bass, MD, K. P

Marcelo G. Cardarelli, MD, James S. Gammie, MD, James M

Cleft on tricuspid anterior leaflet

Right ventricle-sparing heart transplant: promising new technique for recipients with pulmonary hypertension John A Elefteriades, MD, Costantinos J Lovoulos,

Ebstein’s Anomaly of the Tricuspid Valve in Combination of Tetralogy of Fallot: Total Correction in Infancy Chao-Han Lai, MD, Jing-Ming Wu, MD, Yu-Jen.

Absence of Posterior Mitral Leaflet With Secundum Atrial Septal Defect

Divided Left Atrium (Cor Triatriatum) in the Setting of Common Atrium

Resolution of Heart Block After Surgical Correction of Failed Transcatheter Aortic Valve Implantation Alexander Weymann, MD, Nikhil Prakash Patil, MRCS,

Presentation transcript:

Ventricularization of the atrialized chamber: A concept of Ebstein's anomaly repair Michael V. Ullmann, MD, Sabine Born, MD, Christian Sebening, MD, Matthias Gorenflo, MD, Herbert E. Ulmer, MD, Siegfried Hagl, MD The Annals of Thoracic Surgery Volume 78, Issue 3, Pages 918-924 (September 2004) DOI: 10.1016/j.athoracsur.2004.02.134

Fig 1 Intraoperative situs (top) photograph, (middle) schematic illustration of (top) from the surgeon's view, and schematic cross-sectional view (bottom, posterior tricuspid leaflet not indicated) indicating the typical features of Ebstein's anomaly in a 37-year-old patient with downward displacement of the septal tricuspid leaflet (top, middle, bottom) and posterior tricuspid leaflet (top, middle), forming the atrialized ventricle (middle, arrow) and partial adherences of the anterior tricuspid leaflet (bottom). (PA = pulmonary artery; RA = right atrium.) The Annals of Thoracic Surgery 2004 78, 918-924DOI: (10.1016/j.athoracsur.2004.02.134)

Fig 2 Same patient illustrated in Fig 1. Intraoperative situs (top) photograph, (middle) schematic illustration of (top) from the surgeon's view, and schematic cross-sectional view (bottom) indicating ventricularization by reimplantation of the detached septal tricuspid leaflet (STL) (top, middle, bottom, arrow on the left side) and posterior tricuspid leaflet (PTL) (top, middle) at the atrioventricular junction (suture lines [middle] and detachment of adherences of the anterior tri-cuspid leaflet (ATL) [bottom, two arrows on the right side]). (CS = coronary sinus.) The Annals of Thoracic Surgery 2004 78, 918-924DOI: (10.1016/j.athoracsur.2004.02.134)

Fig 3 Same patient illustrated in Fig 1. Intraoperative situs (top) photograph, (middle) schematic illustration of (top) from the surgeon's view, and schematic cross-sectional view (bottom) indicating the final result of Ebstein's anomaly repair after valvuloplasty creating a monocuspid valve using the anterior tricuspid leaflet (ATL) and parts of the posterior tricuspid leaflet (PTL) with combined ventricularization of the atrialized ventricle after orthotopic transposition of the septal tricuspid leaflet (STL) and parts of the PTL. The arrow indicates the pledgeted suture positioned to reinforce the running fixation suture of the transposed STL and PTL. (CS = coronary sinus.) The Annals of Thoracic Surgery 2004 78, 918-924DOI: (10.1016/j.athoracsur.2004.02.134)

Fig 4 Final result of Ebstein's anomaly repair in a 6-year-old patient after creation of a bicuspid atrioventricular valve using the anterior tricuspid leaflet (ATL) and posterior tricuspid leaflet (PTL) with combined ventricularization of the atrialized ventricle after orthotopic transposition of the septal tricuspid leaflet (STL) and PTL. The arrow indicates the pledgeted suture positioned to reinforce the running fixation suture of the transposed STL and PTL. The Annals of Thoracic Surgery 2004 78, 918-924DOI: (10.1016/j.athoracsur.2004.02.134)

Fig 5 Final result of Ebstein's anomaly repair in a 14-year-old patient after creation of a monocuspid valve using the anterior tricuspid leaflet and parts of the posterior tricuspid leaflet (PTL) with combined ventricularization of the atrialized ventricle after orthotopic transposition of the septal tricuspid leaflet (STL) and parts of the PTL. The arrows indicate the pledgeted sutures positioned to reinforce the running fixation suture of the transposed STL and PTL. The Annals of Thoracic Surgery 2004 78, 918-924DOI: (10.1016/j.athoracsur.2004.02.134)

Fig 6 Preoperative two-dimensional echocardiogram (apical four-chamber view) of a 5-year-old patient diagnosed with Ebstein's anomaly exhibiting apical displacement of the tricuspid valve (TV) (arrow), atrialized right ventricle (aRV), and enlarged right atrium (RA). (LA = left atrium; LV = left ventricle; MV = mitral valve; RV = right ventricle.) The Annals of Thoracic Surgery 2004 78, 918-924DOI: (10.1016/j.athoracsur.2004.02.134)

Fig 7 Postoperative two-dimensional echocardiogram (apical four-chamber view) of the same patient as in Figure 6 after Ebstein's anomaly repair depicting normalization of right ventricular geometry after ventricularization of the former atrialized right ventricle (RV) with transposition of the tricuspid valve (TV) at the level of the true tricuspid annulus. Color Doppler indicates mild right atrioventricular valve regurgitation. (LV = left ventricle; MV = mitral valve; RA = right atrium.) The Annals of Thoracic Surgery 2004 78, 918-924DOI: (10.1016/j.athoracsur.2004.02.134)

Fig 8 Graph illustrating the significant improvement of actual tricuspid valve function after Ebstein's anomaly repair compared with preoperative findings (p < 0.0001; circle = median, error bars = standard deviation). (FU = follow-up; TI = tricuspid insufficiency.) The Annals of Thoracic Surgery 2004 78, 918-924DOI: (10.1016/j.athoracsur.2004.02.134)