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Ann Thorac Surg 1994;57:1084-1088
© 1994 The Society of Thoracic Surgeons

Articles

Operation for the Wolff-Parkinson-White syndrome in the Catheter ablation era

Gerard M. Guiraudon, MD*, Colette M. Guiraudon, MD, George J. Klein, MD, Raymond Yee, MD, Ranjan K. Thakur, MD

Department of Surgery, Pathology, and Medicine, University of Western Ontario, University Hospital, London, Ontario, Canada

* Address reprint requests to Dr Guiraudon, University Hospital, 339 Windermere Rd, London, Ont N6A 5A5, Canada.

Catheter ablation has greatly altered surgical referral patterns for the Wolff-Parkinson-White syndrome. We describe 51 patients (aged 9 to 63 years; 35 male, 16 female) referred for operation from our institution and elsewhere between August 1990 and August 1993, coincident with the inception of our ablation program. During the same period, 375 patients with problematic Wolff-Parkinson-White syndrome had ablation procedures. Operation was the initial therapy in 26 patients, due to physician preference in 23 and the need for a concomitant cardiac operation in 3. Operation was related to ablation failure in 22 patients and was urgent in 3 patients. Previous ablation was not associated with added surgical difficulties, and all pathways were ablated intraoperatively on the first attempt using the epicardial approach. Visible epicardial lesions were observed in 8 patients at the site of the accessory pathway. In 2 patients, the lesions were remote to the atrioventricular ring. There was a striking significant increase in proportion of right free wall pathways after attempted ablation (27% versus 8%) as compared with the preablation era. We conclude that previous attempted ablation does not impair efficacy and safety of operative therapy. Operation remains a useful alternative for ablation failure and as a back-up for acute complications.




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G. M. Guiraudon
Surgical treatment of Wolff-Parkinson-White syndrome: A "retrospectroscopic" view
Ann. Thorac. Surg., October 1, 1994; 58(4): 1254 - 1261.
[Abstract] [PDF]


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Copyright © 1994 by The Society of Thoracic Surgeons.