J.Jpn. Surg. Soc.. 81(9): 1015-1019, 1980

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Report on the annual meeting

SURGICAL TREATMENT OF TACHYARRHYTHMIA

Surgical treatment of tachyarrhythmias were done on 31 cases of WPW syndrome, one case of concealed WPW syndrome, and three cases of malignant ventricular arrhythmia. Excluding two cases of children, 29 cases of WPW syndrome were completely relieved from the tachycardial attack after surgical interruption of accessory conduction pathway (ACP). Five of them had multiple ACPs, although four of them required second operation. The location of the ACP including the multiple ACP cases were left cardiac type: 14, right cardiac: 12, and septal: 8.
As the preoperative examination, ECG, body surface mapping, UCG, and intra-cavitary electrophysiological study were valuable in determination of the location of the ACP. Intra-operative epicardial mapping was an indispensable study in final localizing the ACP. There were three cases of malignant ventricular arrhythmia. One case appeared in ischemic heart disease was treated by aneurysmectomy with aorto-coronary bypass. The second case with cardiomyopathy was corrected by ventriculotomy of the ectopic focus area detected by intraoperative epicardial mapping. And the recent third case of 13 years old boy with idiopathic ventricular tachycardia was relieved by a partial resection of the right ventricle near the outflow tract followed by wide cryosurgical ablation of the endocardium including the septum, which brought complete disappearance of the ventricular tachycardia without medication.

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