The Peacock Tail Technique: A Modified Reconstruction Technique for Tricuspid Valve Repair in Ebstein's Malformation

The “peacock tail” technique is a modification of the cone reconstruction technique for Ebstein's malformation and failing right ventricle and is performed simultaneously with a bidirectional cavopulmonary shunt. The technique consists of total detachment of the posterior and anterior tricuspid valve leaflets, which are rotated simultaneously clockwise and counterclockwise and sutured at the midseptal leaflet level, forming a new tricuspid valve (TV). The constructed cone-shaped valve is then attached in its entire circumference to the true tricuspid annulus.