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Takashi Iwa
Tatsuo Magara
Yoh Watanabe
Michio Kawasuji
Takuro Misaki
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Ann Thorac Surg 1980;30:313-325
© 1980 The Society of Thoracic Surgeons

Articles

Interruption of Multiple Accessory Conduction Pathways in the Wolff-Parkinson-White Syndrome

Takashi Iwa, M.D.*, Tatsuo Magara, M.D., Yoh Watanabe, M.D., Michio Kawasuji, M.D., Takuro Misaki, M.D.

From the Department of Surgery, Kanazawa University School of Medicine, Kanazawa, Japan

* Address reprint requests to Dr. Iwa, Department of Surgery, Kanazawa University School of Medicine, Takaramachi 13-1, Kanazawa 920, Japan

Of 35 patients with Wolff-Parkinson-White syndrome operated on, 5 were seen with two accessory 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.




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