SUCCESSFUL SURGICAL CORRECTION OF WOLFF-PARKINSON-WHITE SYNDROME (TYPE B)

EPORT OF A CASE ASSOCIATED WITH MITRAL STENOSIS

Abstract

A surgical interruption of accessory pathway was attempted in a 32-year-old female of Wolff-Parkinson-White (WPW) syndrome associated with mitral stenosis because of several episodes of syncopal attacks and a possibility of hemodynamic deterioration following tachyarrhythmia. A presence of bundle of Kent was suggested by preoperative pacing study, while an epicardial mapping revealed that the earliest point of premature ventricular activation was at the right ventricle near the atrioventricular sulcus. Following a transverse cut on the endocardial surface of the right atrium close to the A-V ring, the delta waves disappeared. Postoperative epicardial mapping revealed that the apex of the right ventricle was the earliest activated site. Open mitral commissurotomy was performed thereafter.
Although the surgical interruption of the accessory pathway is still in experimental stage, the surgical treatment should be considered when WPW syndrome is associated with disabling tachyarrhythmias resistant to medical treatment or mitral valvular disease requiring operative intervention.