Surgical treatment of Wolff-Parkinson-White syndrome in infants and children.
Electrophysiologic features and surgical results were examined in 55 pediatric patients who underwent surgical accessory pathway division for Wolff-Parkinson-White syndrome. There were 31 male and 24 female patients ranging in age from 4 months to 15 years (mean age, 9.8 +/- 4.2 years; 25 patients were less than 10 years old; 4 patients were less than 12 months). Eleven of these patients had associated congenital heart disease and underwent concomitant surgical procedures to treat those conditions. Preoperative effective refractory period of antegrade accessory pathways, the right atrium, atrioventricular node, and cycle length during reentrant tachycardia were shorter in pediatric patients than in adult patients. Antegrade accessory pathways showed right predominance more frequently in the pediatric group than in the adult group. Surgical techniques included an endocardial approach (an epicardial approach was used in 1 patient) and concomitant operation for combined heart disease. The early mortality rate was 3.6%, whereas no late deaths occurred during the follow-up period of 96.8 +/- 54.9 months (maximum follow-up, 205 months). The absolute cure rate was 92%. There were no significant differences in early and late mortality between pediatric and adult patients. Surgical treatment of the Wolff-Parkinson-White syndrome in pediatric patients is as safe and effective as in adults. Considering the potential complications from prolonged fluoroscopic exposure during catheter ablation, surgical division of accessory pathways in children is a promising modality for the treatment of Wolff-Parkinson-White syndrome in selected cases.
First Department of Surgery, Toyama Medical and Pharmaceutical University, Japan.
T
T
Misaki
G
G
Watanabe
T
T
Iwa
Y
Y
Matsunaga
H
H
Ohtake
M
M
Tsubota
M
M
Takahashi
Y
Y
Watanabe
D000293:Adolescent; D000328:Adult; D002304:Cardiac Pacing, Artificial / Q000379:methods; D017115:Catheter Ablation; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000601:surgery*; D006330:Heart Defects, Congenital / Q000150:complications / Q000601:surgery; D006801:Humans; D007223:Infant; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D013997:Time Factors; D014927:Wolff-Parkinson-White Syndrome / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*