Surgical treatment of patients with Wolff-Parkinson-White syndrome and associated Ebstein's anomaly.
Ebstein"s anomaly is the most common congenital heart disease associated with the Wolf-Parkinson-White syndrome. Between November 1973 and March 1993, we surgically treated 42 patients with Wolff-Parkinson-White syndrome and Ebstein's anomaly. The patient's ages ranged from 5 months to 59 years (mean 35.3 +/- 14.0 years). There were a total of 52 accessory pathways, 48 of which were located in the right (65%) or posteroseptal (29%) area. A left-sided accessory pathway was seen in only two patients (3.8%). Division of all right-sided accessory pathways was done during normothermic cardiopulmonary bypass with the heart beating; cryocoagulation was applied together with scalpel dissection of the atrioventricular groove. Division of the left-sided accessory pathways was done with the use cold potassium cardioplegic arrest. Thirty-five of these patients underwent tricuspid valve operation for Ebstein's anomaly and 11 of them underwent tricuspid valve replacement with a bioprosthesis. All 52 accessory pathways were successfully divided, although two patients required reoperation because of tachycardia caused by accessory pathways in different positions. Three hospital deaths (7.1%) occurred. There were no late deaths during the follow-up period (mean 94.3 +/- 52.4 months), but two patients required repeat tricuspid operation because of progression of the tricuspid regurgitation. Because no repeat operations were required during long-term follow-up patients who underwent valve repair or valve replacement, correction should be indicated in some patients.
Department of Surgery (1), Toyama Medical and Pharmaceutical University, Japan.
T
T
Misaki
G
G
Watanabe
T
T
Iwa
Y
Y
Watanabe
K
K
Mukai
M
M
Takahashi
H
H
Ohtake
K
K
Yamamoto
D000328:Adult; D001705:Bioprosthesis; D002315:Cardiopulmonary Bypass; D003452:Cryosurgery; D004437:Ebstein Anomaly / Q000150:complications* / Q000453:epidemiology / Q000601:surgery*; D005500:Follow-Up Studies; D006324:Heart Arrest, Induced; D006350:Heart Valve Prosthesis; D006801:Humans; D016015:Logistic Models; D012086:Reoperation; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000601:surgery; D014927:Wolff-Parkinson-White Syndrome / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery*