Surgical Treatment of the Wolff-Parkinson-White Syndrome

Wolff-Parkinson-White 증후군의 외과적 치료

  • 박남희 (계명대학교 의과대학 흉부외과학교실) ;
  • 이광숙 (계명대학교 의과대학 흉부외과학교실)
  • Published : 1996.12.01

Abstract

From October 1993 to February 1996, 9 patients with Wolfr-Parkinson-White syndrome underwent surgical ablation of the accessory atrioventricular conduction pathways. The indications for surgical ablation we e radiofrequency ablation failure in 6 cases, multiple accessory pathways in 1 case, catheter tip fracture ducting catheter ablation in 1 case and additional procedure(redo mitral valve replacement due to valve thrombosis) in 1 case. There was no operative mortality. The postoperative complications were noted In 2 cases pericardial effusion and wound Infection. All patients had accessory atrioventricular connections ablated which were proven by surface ECG and follow-up electrophysiologic study and have remained free of symptomatic tachycardia. The indications for surgical treatment of Wolff-Parkinson-White syndrome are radiofrequency ablation failure, multiple pathways, or when additional procedures are required The present results were satisfactory.

1993년 10월부터 1996년 2월까지 9명의 Wolfr-Parkinson-White증후군을 가진 환자에서 우회로의 외과적 절제술을 시행하였다. 수술적응례를 살펴보면 도자절제술이 실패한 경우가 6례, 우회로가 2개 있었던 경우와 도자절제술중 도자 말단부위가 부러졌던 경우가 1례씩 있었으며, 나머지 1례는 승모판막재치환술이 필요했던 경우이다. 수술사망은 없었으며 술후합병증은심낭삼출액과 창상감염이 각각 1례씩 있었다. 모든 환자에서 술후 심전도검사 및 전기생리검사를 통해 우회로가 완전 절제되었슴을 확인할 수 있었으며 추적 관찰기간중 인맥을 보인 환자는 없었다. 이상의 결과로 Wolfr-Parkinson-White증후군에서 우회로의 외과적 절제는 도자절제술이 실패한 경우, 우회로가 여러개 있는 경우, 그리고 동반된 심질환의 교정을 요하는 경우로 국한되며 수술적응례에서 외과적 절제술은 비교적 안전하고 효과적인 치료방법으로 사료된다.

Keywords

References

  1. West J Med v.152 Current management of the Wolff-Parkinson-White syndrome Arai,A.;Kron,J.
  2. Circulation v.38 Successful surgical interruption of the bundle of Kent in patient with Wolff-Parkinson-White syndrome Cobb,F.R.;Blumenschein,S.D.;Sealy,W.C.(et al.)
  3. Surgery of the chest(6th ed.) The surgical management of cardiac arrythmias James,L.Cox.;Sabiston,D.C.;Spencer,F.C.
  4. Eur Heart J v.14 no.Supplement E Surgical treatment of the Wolff-Parkinson-White syndrome-experiences in 120 patients D.Lowes;G.Frank;J.Klein;M.Manz
  5. Semin Thorac Cardiovasc Surg v.1 Surgery of the Wolff-Parkinson-White syndrome : The endocardial approach Cox,J.L.;Ferguson,T.B.Jr.
  6. Cardiac Surgery The epicardial technique for left free-wall accessory pathways Penn,O.C.;Cox,J.L.(ed.)
  7. Eur Heart J v.10 Cost-benefit analysis of medical vs surgical treatment of symptomatic patients with accessory atrioventricular pathways Lezaun,R.;Brugada,P.;Smeets,T.(et al.)
  8. Ann Thorac Surg v.52 Current treatment for Wolff-Parkinson-White syndrome: results and surgical implication Bolling,S.F.;Morady,F.;Calkins,H.(et al.)