Cone procedure for Ebstein’s anomaly

Brief Review Cone procedure for Ebstein’s anomaly of tricuspid valve constructs a funnel like valve using the native valve leaflets. This avoids the problems associated with artificial valves including bioprosthetic valves, especially in children. In one study cone procedure group had 85% reduction in tricuspid regurgitation compared to 56% in the conventional group, at discharge from hospital [1]. The cone procedure involves detachment of tricuspid leaflets, division of chordae, plication of the tricuspid annulus, rotation of leaflets and final re-insertion of the leaflets in the modified tricuspid valve annulus [2]. Since Cone procedure has become an effective hemodynamic intervention for Ebstein’s anomaly, late mortality due to arrhythmias assume more importance. Periprocedural electrophysiological study and ablation of potential arrhythmic circuits have been suggested as a preventive strategy [3]. This aggressive protocol documented significant electrophysiological findings in 69% (29 of 42 patients), including 8 patients in whom there was no prior suspicion of arrhythmia. Seventeen of these patients underwent catheter ablation while the remainder had intra operative interventions. The strategy could prevent sudden death in those treated with this protocol. Real time intraoperative three dimensional transesophageal echocardiographic guidance for Cone procedure has been used successfully as in case of mitral valve repair [4]. References Vogel M, Marx GR, Twor...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiac Surgery Cone procedure Ebstein's anomaly Source Type: blogs