SUCCESSFUL TREATMENT OF WOLFF-PARKINSON-WHITE SYNDROME WITH CONCOMITANT MITRAL-STENOSIS BY SIMULTANEOUS SURGERY

We report the case of a 61-year-old man with type B Wolff-Parkinson-Wh ite (WPW) syndrome associated,vith a right atrioventricular (AV) acces sory pathway and concomitant mitral stenosis, who underwent successful operative treatment by simultaneous surgery His preoperative course h ad been characterized by cardiac failure and repeated episodes of atri al tachyarrhythmia, in the form of fibrillation and flutter, ,which we re difficult to control by conventional medication, Preoperative elect rocardiograms (ECGs) had suggested that the accessory pathway was loca ted in the right posterior to posteroseptal wall; however, at the time of surgery, epicardial electrophysiological mapping with sock electro des revealed a preexcitation area in the AV groove at the lateral righ t margin of the heart, This discrepancy was thought to have been due t o the presence of mitral stenosis or multiple accessory pathways, Thus , division and cryoablation of the accessory pathway by an endocardial approach, in addition to mitral valve replacement, were performed und er cardiopulmonary bypass. His postoperative course was uneventful, an d subsequent ECGs revealed that the delta waves had disappeared, The s uccessful outcome of this patient demonstrates the effectiveness of si multaneous surgery for WPW syndrome associated with valvular disease.