The Annals of Thoracic Surgery, Vol 58, 103-107, Copyright © 1994 by The Society of Thoracic Surgeons
Surgical treatment of Wolff-Parkinson-White syndrome in infants and children
T Misaki, G Watanabe, T Iwa, Y Matsunaga, H Ohtake, M Tsubota, M Takahashi and Y Watanabe
First Department of Surgery, Toyama Medical and Pharmaceutical University, Japan.
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.
