The surgical section of the bundle of Kent as an operative treatment of the Wolff-Parkinson-White syndrome: apropos a series of 82 operated cases

Eighty two patients diagnosed of the Wolff-Parkinson-White syndrome (WPW) underwent operation for the surgical section of the Kent-His bundle. In these cases, posteroseptal localization (PS) occurred in 32, left lateral (LL) in 25, right lateral (RL) in six, anteroseptal (AS) in one, posteroseptal and left lateral in 14, right and left posteroseptal in two, anteroseptal and left lateral in one, and left lateral and right and left posteroseptal in one. All of the patients presented an invalidating clinical of palpitations and/or loss of consciousness, and episodes of atrial fibrillation and/or reciprocal rhythm were registered in all cases. The mean anterograde refractory period in the accessory pathways was 244 +/- 60 msec, and the shortest RR in atrial fibrillation was 190 +/- 36 msec. A mitral commissurotomy was carried out in 3 patients during surgery, mitral prostheses were implanted in two, a double aorto-coronary bypass was made in three and an interventricular communication was closed in one. After a follow-up of 36 +/- 18 months, the surgical section of the Kent bundle was found to be effective in 77 out 82 patients (94%). (In 70 out of 77 cases, both anterograde and retrograde conduction were totally abolished and in seven out of 77 obtunded. All patients were asymptomatic during the follow-up period). In 5 out of 82 patients, surgical treatment was ineffective all five showed a PS Kent-His and two presented a second Kent-His fascicle (LL).(ABSTRACT TRUNCATED AT 250 WORDS)