[Surgical treatment of Wolff-Parkinson-White syndrome--experiences with 87 surgically treated patients].
[Surgical treatment of Wolff-Parkinson-White syndrome--experiences with 87 surgically treated patients].
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Original abstract
Since January 1984, 87 patients (pts) (57 male, 30 female; age 3 to 64 years) with Wolff-Parkinson-White syndrome were operated upon. The indication for surgical treatment was documented recurrent, paroxysmal tachycardia refractory to medical treatment in 85 cases. Eleven pts (13%) had additional heart disease. 87 pts had a total of 103 accessory pathways (AP). AP was localized at the left free wall in 68% (70 AP), at the right free wall in 16% (16 AP), and localized septally in 17% (17 AP). Thirteen pts (15%) had multiple AP (10 pts had two and three pts had three AP). 87 AP were known preoperatively, 96 were localized intraoperatively, and seven were diagnosed during reoperation. Twenty-seven pts were left lateral AP were operated by the epicardial approach and 37 pts by the endocardial approach. Patients with right lateral AP were approached by an epicardial technique in six cases, and by a transmural technique in five. Cryotechnique was applied additionally in 85 pts. Twelve pts suffered recurrences, 11 were reoperated. 101 AP (98%) were dissected successfully, of which 13 (13%) were ablated during reoperation. All pts survived the initial operation. Two pts died after reoperation. One pt is pacemaker-dependent due to a persisting postoperative AV block. We conclude that surgical dissection of accessory pathways can now be offered as an alternative to the non-surgical treatment modes, with low risk and yielding a high success rate.