{"id":19887,"date":"2015-11-22T13:45:52","date_gmt":"2015-11-22T08:15:52","guid":{"rendered":"https:\/\/cardiophile.org\/?p=19887"},"modified":"2015-11-22T13:45:52","modified_gmt":"2015-11-22T08:15:52","slug":"cone-procedure-for-ebsteins-anomaly","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/cone-procedure-for-ebsteins-anomaly\/","title":{"rendered":"Cone Procedure for Ebstein&#8217;s anomaly"},"content":{"rendered":"<h2><span style=\"color: #008000;\">Cone Procedure for Ebstein&#8217;s anomaly<\/span><\/h2>\n<p><iframe loading=\"lazy\" width=\"560\" height=\"315\" src=\"https:\/\/www.youtube.com\/embed\/KU0sPRXsTrA\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen=\"\"><\/iframe><\/p>\n<p>Cone procedure for Ebstein&#8217;s anomaly of tricuspid valve constructs a funnel like valve using the native valve leaflets [1]. This <span style=\"color: #0000ff;\">avoids the problems associated with artificial valves including bioprosthetic valves, especially in children<\/span>. In one study cone procedure group had 85% reduction in tricuspid regurgitation compared to 56% in the conventional group, at discharge from hospital [2]. 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 [3].<\/p>\n<p>Since Cone procedure has become an effective hemodynamic intervention for Ebstein&#8217;s anomaly, late mortality due to arrhythmias assume more importance. <span style=\"color: #0000ff;\">Periprocedural electrophysiological study and ablation of potential arrhythmic circuits<\/span> have been suggested as a preventive strategy [4]. 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 intraoperative interventions. <span style=\"color: #0000ff;\">The strategy could prevent sudden death in those treated with this protocol.<\/span><\/p>\n<p>Real time intraoperative three dimensional transesophageal echocardiographic guidance for Cone procedure has been used successfully as in case of mitral valve repair [5].<\/p>\n<p><strong><span style=\"color: #0000ff;\">References<\/span><\/strong><\/p>\n<ol>\n<li>Jos\u00e9 Pedro da Silva, Jos\u00e9 Francisco Baumgratz, Luciana da Fonseca, S\u00f4nia Meiken Franchi, Lilian Maria Lopes, Gl\u00e1ucia Maria P Tavares, Andressa Mussi Soares, Luiz Felipe Moreira, Miguel Barbero-Marcial. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/17198815\/\">The cone reconstruction of the tricuspid valve in Ebstein&#8217;s anomaly. The operation: early and midterm results<\/a>. J Thorac Cardiovasc Surg. 2007 Jan;133(1):215-23.<\/li>\n<li>Vogel M, Marx GR, Tworetzky W, Cecchin F, Graham D, Mayer JE, Pigula FA, Bacha EA, Del Nido PJ. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/22176641\">Ebstein&#8217;s malformation of the tricuspid valve: short-term outcomes of the &#8220;cone procedure&#8221; versus conventional surgery<\/a>.&nbsp;Congenit Heart Dis. 2012 Jan-Feb;7(1):50-8.<\/li>\n<li>Pizarro C, Bhat MA, Temple J. Cone reconstruction and ventricular septal defect closure for neonatal Ebstein&#8217;s anomaly.&nbsp;Multimed Man Cardiothorac Surg. 2012 Jan 1;2012:mms014.<\/li>\n<li>Shivapour JK, Sherwin ED, Alexander ME, Cecchin F, Mah DY, Triedman JK, Marx GR, del Nido PJ, Walsh EP. Utility of preoperative electrophysiologic studies in patients with Ebstein&#8217;s anomaly undergoing the Cone procedure.&nbsp;Heart Rhythm. 2014 Feb;11(2):182-6.<\/li>\n<li>Sujatha M, Gadhinglajkar S, Dharan BS, Sreedhar R. Role of Intraoperative Real-Time Three-Dimensional Transesophageal Echocardiography During Cone Procedure for Ebstein&#8217;s Anomaly. J Cardiothorac Vasc Anesth. 2016 Jan;30(1):176-8.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Cone procedure for Ebstein&#8217;s anomaly: detachment of leaflets, division of chordae, plication of annulus, rotation of leaflets and re-insertion of leaflets in neoannulus<\/p>\n","protected":false},"author":1,"featured_media":40750,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[22],"tags":[862,1261],"class_list":["post-19887","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cardiac-surgery","tag-cone-procedure","tag-ebsteins-anomaly"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Cone Procedure for Ebstein&#039;s anomaly - is a promising surgical option<\/title>\n<meta name=\"description\" content=\"Cone procedure for Ebstein&#039;s anomaly: detachment of leaflets, division of chordae, plication of annulus, rotation of leaflets and re-insertion.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/cone-procedure-for-ebsteins-anomaly\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Cone Procedure for Ebstein&#039;s anomaly - 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