The Annals of Thoracic Surgery, Vol 51, 563-572, Copyright © 1991 by The Society of Thoracic Surgeons
Surgical treatment of the Wolff-Parkinson-White syndrome by epicardial electrical ablation
LA Bockeria, NI Kupatadze, DB Saprigin, IP Aslanidi, NA Chigogidze, AM Dyadyurko and LM Poplavskaya
Department of Arrhythmias, A. N. Bakoulev Institute of Cardiovascular Surgery, Academy of Medical Sciences of the USSR, Moscow.
A new operation to eliminate accessory pathways--epicardial electrical
ablation--is described. In a group of 201 patients without concomitant
disease, the mortality rate was 0.5% and the overall efficacy of the
operation for free wall accessory pathways, 98%. A retrospective clinical
study of 44 unselected patients was performed to examine how safe
epicardial electrical ablation is. The criteria for intraoperative
effectiveness were disappearance of both the delta wave and retrograde
conduction and inability to induce tachycardia. In the postoperative and
follow-up periods, the following were reviewed: electrocardiograms; Holter
monitor recordings (24 to 26 hours); release of the myocardial- specific
isoenzyme of creatine kinase; intracardiac hemodynamics and myocardial
contractility (radionuclide methods); selective coronary arteriograms and
ventriculograms; mean work capacity (bicycle ergometer); diagnostic
transesophageal electrical stimulation; and histology of the area of
ablation. The main conclusion of this study is that epicardial electrical
ablation is a highly efficient and safe operation for surgical elimination
of parietal accessory pathways in patients with Wolff-Parkinson-White
syndrome. Its advantages are its technical simplicity and the opportunity
to review results immediately during the operation.
