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Superficial accessory pathway in the Wolff-Parkinson-white syndrome—Electrophysiological, surgical and histologic demonstration
Authors:M.D. William J. Untereker   M.D. Robert S. Litwak   M.D. Bruce P. Mindich   B.S. George Wiemann   M.D. Steven Goldberg   M.D. Richard Gorlin  M.D. Joel Kupersmith
Abstract:A superficial accessory pathway was demonstrated by electrophysiologic techniques and surgical histopathology in a 30-year-old male with Wolff-Parkinson-White syndrome, severe mitral valve disease and medically uncontrollable arrhythmias. In this patient, electrode catheter studies in the cardiac catheterization laboratory revealed antegrade and retrograde function of an accessory pathway between the anterior right atrium and the right ventricle. During surgery, electrophysiologic mapping confirmed the anterior location of this pathway. Blunt dissection in the fat pad of the A-V groove between the right atrium and ventricle revealed the accessory pathway which consisted of tissue strands superficial to the A-V ring. These were removed and on histological examination were composed of ordinary myocardial cells. Concomitant recarried out. Postoperatively, there was complete regression of the preexcitation and arrhythmias.
Keywords:Reprint requests to: William J. Untereker   M.D.   Cardiovascular Section   Hospital of the University of Pennsylvania   3400 Spruce Street   Philadelphia   PA 19104.
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