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

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Presentation on theme: "The cone reconstruction of the tricuspid valve in Ebstein’s anomaly"— Presentation transcript:

1 The cone reconstruction of the tricuspid valve in Ebstein’s anomaly
The cone reconstruction of the tricuspid valve in Ebstein’s anomaly. The operation: early and midterm results  José Pedro da Silva, MD, José Francisco Baumgratz, MD, Luciana da Fonseca, MD, Sônia Meiken Franchi, MD, Lilian Maria Lopes, MD, Gláucia Maria P. Tavares, MD, Andressa Mussi Soares, MD, Luiz Felipe Moreira, MD, Miguel Barbero-Marcial, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume 133, Issue 1, Pages (January 2007) DOI: /j.jtcvs Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

2 Figure 1 Operative steps for Ebstein’s anomaly repair. A, Opened right atrium showing displacement of the tricuspid valve. TTA, True tricuspid annulus; ASD, atrial septal defect; CS, coronary sinus. B, Detached part of the anterior and posterior leaflet forming a single piece. C, Clockwise rotation of the posterior leaflet edge to be sutured to the anterior leaflet septal edge and plication of the true tricuspid annulus. D, Complete valve attachment to the true tricuspid annulus and valved closure of the atrial septal defect. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

3 Figure 2 Surgical sequence of tricuspid valve repair with incorporation of the septal leaflet. A, Detached septal and posterior leaflets and part of the anterior leaflet of the tricuspid valve. AL, Anterior leaflet; PL, posterior leaflet; SL, septal leaflet. B, Septal leaflet sutured to the posterior and anterior leaflets in a cone shape and the plicated annulus. C, Final aspect after filling the right ventricle with saline. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

4 Figure 3 Echocardiographic aspects. A, Preoperative echocardiogram showing tricuspid valve leaflet downward displacement and enlargement of right-side chambers. B, Postoperative echocardiograms (13 months) showing the tricuspid valve in the correct level and with the anteroposterior diameter smaller than the mitral valve. C, Opening and closing sequence of the repaired tricuspid valve. SYST, Systole; RA, right atrium; RV, right ventricle; LA, left atrium; LV, left ventricle; AL, anterior leaflet; SL, septal leaflet; DIAST, diastole; T, anteroposterior tricuspid valve annulus diameter; M, anteroposterior mitral valve annulus diameter. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

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