Key result
Surgical accessory pathway interruption eliminates delta waves in a patient with WPW and mitral stenosis.
Why the study?
Surgical interruption of the accessory pathway in WPW syndrome is still experimental but may be considered when tachyarrhythmias are resistant to medical treatment or mitral valvular disease requires surgery.
Does surgical interruption of the accessory pathway eliminate delta waves in a patient with WPW syndrome and mitral stenosis?
Case Report (n=1)
No
Does surgical interruption of the accessory pathway eliminate delta waves in a patient with WPW syndrome and mitral stenosis?
Surgical interruption of the accessory pathway can be successfully performed in patients with WPW syndrome requiring operative intervention for associated mitral valvular disease.
Supports combined surgical approach in WPW with mitral stenosis; extends sparse case evidence but leaves generalizability open.
A surgical interruption of accessory pathway was attempted in a 32-year-old female of Wolff-Parkinson-White (WPW) syndrome associated with mitral stenosis because of several episodes of syncopal attacks and a possibility of hemodynamic deterioration following tachyarrhythmia. A presence of bundle of Kent was suggested by preoperative pacing study, while an epicardial mapping revealed that the earliest point of premature ventricular activation was at the right ventricle near the atrioventricular sulcus. Following a transverse cut on the endocardial surface of the right atrium close to the A-V ring, the delta waves disappeared. Postoperative epicardial mapping revealed that the apex of the right ventricle was the earliest activated site. Open mitral commissurotomy was performed thereafter.Although the surgical interruption of the accessory pathway is still in experimental stage, the surgical treatment should be considered when WPW syndrome is associated with disabling tachyarrhythmias resistant to medical treatment or mitral valvular disease requiring operative intervention.
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Ida et al. (1978) conducted a case report in Wolff-Parkinson-White (WPW) syndrome (Type B) associated with mitral stenosis (n=1). Surgical interruption of accessory pathway and open mitral commissurotomy was evaluated on Disappearance of delta waves. Surgical interruption of the accessory pathway successfully eliminated delta waves in a 32-year-old female with Wolff-Parkinson-White syndrome and mitral stenosis.
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