title: Interruption of multiple accessory conduction pathways in the Wolff-Parkinson-White syndrome.
abstract: Of 35 patients with Wolff-Parkinson-White syndrome operated on, 5 were seen with two accesory conduction pathways each; all of these were successfully interrupted. In one patient, one accessory conduction pathway each was located in the right and left side of the heart; in the other 4, both pathways were confined to the right side. In 2 patients with unilateral (right side) multiple accessory conduction pathways, Ebstein's anomaly was also present. In 1 patient with Ebstein's anomaly, the second unilateral accessory conduction pathway was discovered intraoperatively and was successfully interrupted. The remaining 4 patients required a second operation to interrupt the other pathway. A delta wave completely different from the preoperative one appeared 4 to 10 days after interruption of the first major pathway, and the second operation was performed 14 days, 42 days, four months, or five years after the first operation. All 5 patients survived, and long-term follow-up revealed no signs of morbidity.
mesh_terms: D000293:Adolescent; D000328:Adult; D004437:Ebstein Anomaly / Q000150:complications; D004562:Electrocardiography; D006329:Heart Conduction System / Q000002:abnormalities*; D006801:Humans; D008297:Male; D014927:Wolff-Parkinson-White Syndrome / Q000150:complications / Q000503:physiopathology / Q000601:surgery*