Here is a graphical presentation of the cone procedure

The posterior leaflet of the triscuspid valve is detached from the annulus.

Fenestrations are created at the lower part of the leaflet.

The sub-valve apparatus is also disconnected in order to free the leaflet completely from it's downwards displacement into the ventricle.

The septal leaflet is also disconnected from the annulus.

The septal leaflet being disconnected from the annulus.

The septal and posterior leaflets are then reunited using interrupted stitches.

The plication of the atrialized position of the right ventricle is then performed in order to recreate the new upward located annulus.

The plication of the atrialized position of the right ventricle is then performed in order to recreate the new upward located annulus.

The triscuspid valve is then reattached to the new annulus.

The triscuspid valve is then reattached to the new annulus.

The final shape of the new tricuspid valve is that of a cone? reattached to the new annulus.

The final shape of the new tricuspid valve is that of a cone? reattached to the new annulus.

Technique Complete