This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Guiraudon, G. M. Articles by McLellan, D. G. Search for Related Content PubMed PubMed Citation Articles by Guiraudon, G. M. Articles by McLellan, D. G.

Circulation, Vol 74, 525-529, Copyright © 1986 by American Heart Association

ARTICLES

Surgery for Wolff-Parkinson-White syndrome: further experience with an epicardial approach

GM Guiraudon, GJ Klein, AD Sharma, DL Jones and DG McLellan

We have previously reported the use of an epicardial approach for ablation of left ventricular free wall accessory atrioventricular pathways. The technique involves mobilization of the atrioventricular fat pad and exposure and cryoablation of the atrioventricular junction at the site of the accessory pathway on the normothermic beating heart. Here we describe our further experience with left ventricular free wall accessory pathways and right ventricular free wall accessory pathways. Our experience is based on 53 consecutive patients. There were 35 male and 18 female subjects, 6 to 52 (mean 41.4) years old. Forty-eight patients had a left ventricular free wall accessory pathway, and five had a right ventricular free wall accessory pathway. Two patients had an associated anterior septal accessory pathway. Five patients had associated cardiac abnormalities, including atrial septal defect, aortic insufficiency, mitral valve prolapse, Ebstein's anomaly, and cardiomyopathy. The accessory pathway was ablated in 52 patients who remain arrhythmia free without medication after a mean follow-up period of 12 months. The accessory pathway was permanently modified in one patient. There were no postoperative complications. This epicardial approach can be performed with normothermic cardiopulmonary bypass or without bypass. It does not require cross-clamping of the aorta, allowing a greater margin of safety when this is required for concomitant procedures.

This article has been cited by other articles:

				R. A. Schweikert, W. I. Saliba, G. Tomassoni, N. F. Marrouche, C. R. Cole, T. J. Dresing, P. J. Tchou, D. Bash, S. Beheiry, C. Lam, et al. Percutaneous Pericardial Instrumentation for Endo-Epicardial Mapping of Previously Failed Ablations Circulation, September 16, 2003; 108(11): 1329 - 1335. [Abstract] [Full Text] [PDF]

				B. J. Deal, C. Mavroudis, and C. L. Backer Beyond Fontan conversion: surgical therapy of arrhythmias including patients with associated complex congenital heart disease Ann. Thorac. Surg., August 1, 2003; 76(2): 542 - 554. [Abstract] [Full Text] [PDF]

				F. G. Cosio, R. H. Anderson, K.-H. Kuck, A. Becker, M. Borggrefe, R. W. F. Campbell, F. Gaita, G. M. Guiraudon, M. Haissaguerre, J. J. Rufilanchas, et al. Living Anatomy of the Atrioventricular Junctions. A Guide to Electrophysiologic Mapping : A Consensus Statement from the Cardiac Nomenclature Study Group, Working Group of Arrhythmias, European Society of Cardiology, and the Task Force on Cardiac Nomenclature from NASPE Circulation, August 3, 1999; 100 (5): e31 - e37. [Abstract] [Full Text] [PDF]

				J. Altamirano, R. Wachsner, and D. Gallik Mechanical Ablation of Concealed Left Lateral Bypass Tract Journal of Cardiovascular Pharmacology and Therapeutics, January 1, 1997; 2(3): 223 - 227. [Abstract] [PDF]