{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T04:12:47Z","timestamp":1750824767322,"version":"3.41.0"},"reference-count":34,"publisher":"Georg Thieme Verlag KG","issue":"S 03","license":[{"start":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T00:00:00Z","timestamp":1748217600000},"content-version":"vor","delay-in-days":145,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"KidsHeart International"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac Cardiovasc Surg"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Contemporary surgical approaches for Ebstein anomaly are based on a paradigm shift towards earlier surgery in order to avoid the deleterious effects of chronic right ventricular (RV) volume overload. In addition, RV dysfunction may worsen in the setting of high altitude, and to date, no results on Ebstein anomaly surgery have been reported from a high-altitude setting.<\/jats:p><jats:p>We herein present first postoperative results from Ebstein anomaly patients who underwent cone reconstruction (with or without bidirectional Glenn anastomosis) in Cochabamba, Bolivia (&gt;2,500\u2009m above sea level) using a specific high-altitude protocol for prophylactic medical treatment of presumed pulmonary hypertension (PH), including sildenafil, iloprost, and higher FiO2.<\/jats:p><jats:p>Four patients underwent surgical correction of Ebstein anomaly (median age 9 years, range 4\u201312 years, all female). Ebstein anomaly was classified as Carpentier type C in three and as Carpentier Type B in one patient. All patients showed some degree of atrial shunting while one patient exhibited an additional perimembranous ventricular septal defect. All underwent cone reconstruction of the tricuspid valve. Due to massive intraoperative bleeding, which required rethoracotomy, subsequently causing impaired RV function, one patient underwent concomitant \u201cone and a half ventricle\u201d repair. All other patients showed an uncomplicated postoperative course and all were alive with a good and\/or improved RV function and only minimal-to-mild tricuspid regurgitation after 1 year.<\/jats:p><jats:p>Cone reconstruction in children with Ebstein anomaly is feasible in a high-altitude setting when using a dedicated protocol to prophylactically manage PH.<\/jats:p>","DOI":"10.1055\/a-2620-3643","type":"journal-article","created":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T23:56:16Z","timestamp":1748303776000},"page":"e31-e38","source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Ebstein Repair in a High-Altitude Setting \u22652,500 m: First Experience from Bolivia"],"prefix":"10.1055","volume":"73","author":[{"given":"Sven C.","family":"Weber","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease-Pediatric Cardiology, Deutsches Herzzentrum der Charit\u00e9 (DHZC), Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inge von","family":"Alvensleben","sequence":"additional","affiliation":[{"name":"Kardiozentrum, La Paz, Bolivia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentin","family":"Vadiunec","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Deutsches Herzzentrum der Charit\u00e9 (DHZC), Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andre","family":"Iben","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Surgery-Pediatric Heart Surgery, Deutsches Herzzentrum der Charit\u00e9 (DHZC), Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"Berger","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease-Pediatric Cardiology, Deutsches Herzzentrum der Charit\u00e9 (DHZC), Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannes","family":"Sallmon","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Medical University of Graz, Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joachim","family":"Photiadis","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Surgery-Pediatric Heart Surgery, Deutsches Herzzentrum der Charit\u00e9 (DHZC), Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,6,24]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1002\/tera.1420500208","article-title":"Ebstein's malformation of the tricuspid valve: genetic and environmental factors","volume":"50","author":"A Correa-Villase\u00f1or","year":"1994","journal-title":"Teratology"},{"issue":"08","key":"ref2","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1055\/s-0037-1604469","article-title":"Surgical treatment of Ebstein's anomaly","volume":"65","author":"M Burri","year":"2017","journal-title":"Thorac Cardiovasc Surg"},{"issue":"03","key":"ref3","first-page":"181","article-title":"The right ventricular myocardium in Ebstein's anomaly: A morphometric histopathologic study","volume":"54","author":"K R Anderson","year":"1979","journal-title":"Mayo Clin Proc"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1111\/chd.12155","article-title":"Cone reconstruction in children with Ebstein anomaly: The Mayo Clinic experience","volume":"9","author":"H N Anderson","year":"2014","journal-title":"Congenit Heart Dis"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/j.jtcvs.2006.09.018","article-title":"The cone reconstruction of the tricuspid valve in Ebstein's anomaly. The operation: Early and midterm results","volume":"133","author":"J P da Silva","year":"2007","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"06","key":"ref6","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1016\/S0022-5223(19)36627-9","article-title":"Ebstein's anomaly appearing in the neonate. 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Moons","year":"2021","journal-title":"Eur Heart J"},{"issue":"06","key":"ref33","doi-asserted-by":"crossref","first-page":"1350","DOI":"10.1017\/S1047951124025083","article-title":"Ventricular insertion site ablation of a Mahaim atriofascicular fibre in Ebstein anomaly","volume":"34","author":"S Kurath-Koller","year":"2024","journal-title":"Cardiol Young"},{"issue":"02","key":"ref34","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1007\/s00246-009-9590-3","article-title":"A multicenter, long-term study on arrhythmias in children with Ebstein anomaly","volume":"31","author":"T Delhaas","year":"2010","journal-title":"Pediatr Cardiol"}],"container-title":["The Thoracic and Cardiovascular 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