Zünd G, von Segesser L K, Vogt P, Candinas R, Amann F W, Jenni R, Turina M
Klinik für Herz- und Gefässchirurgie, Universitätsspital Zürich.
Swiss Surg Suppl. 1996;Suppl 1:27-31.
The results of surgical procedures for termination of Wolff-Parkinson-White (WPW) Syndrom were assessed in 59 patients undergoing operation between January, 1980 and December, 1993. All cases of WPW were refractory to medical treatment and 14 of 58 patients had one or several syncopes, and 4 of them had to be reanimated. The surgical treatment of these patients was a dissection of an accessory atrioventricular pathway. 15 patients required additional heart operation. A total of 60 accessory pathways were diagnosed preoperatively, 64 were located intraoperatively. The reoperation rate was 3% (2 patients) due to persistent WPW. Incidence of total AV block after the operation was 7% (4 patients). In the late postoperative stage, 12 patients developed supraventricular tachycardias, but none of these cases required a surgical treatment. The actuarial survival rate after 10 years was 100% and after 14 years 96%. We conclude that surgical dissection of accessory pathways offers a good alternative in cases of unsuccessful catheter ablative procedure or in cases of additional heart operation.
对1980年1月至1993年12月期间接受手术的59例沃尔夫-帕金森-怀特综合征(WPW综合征)患者的手术结果进行了评估。所有WPW综合征病例均对药物治疗无效,58例患者中有14例发生过一次或多次晕厥,其中4例需要复苏。这些患者的手术治疗是切断一条房室旁道。15例患者需要进行额外的心脏手术。术前共诊断出60条旁道,术中发现64条。因WPW综合征持续存在,再次手术率为3%(2例患者)。术后完全性房室传导阻滞的发生率为7%(4例患者)。在术后晚期,12例患者出现室上性心动过速,但这些病例均无需手术治疗。10年时的精算生存率为100%,14年时为96%。我们得出结论,对于导管消融术失败或需要进行额外心脏手术的病例,切断旁道手术是一种很好的选择。