Surgical Procedure for Right Anteroseptal Accessory Conduction Pathways in Wolff-Parkinson-White Syndrome

In patients with Wolff-Parkinson-White syndrome, the right anteroseptal accessory conduction pathway is rare, and exists from the atrium to the ventricle in close anatomic proximity to the normal atrioventricular conduction system. Catheter ablation of this lesion is reported to interrupt atrioventricular node-His bundle conduction more easily than that of other lesions. At our institute, there were 10 patients with right anteroseptal accessory conduction pathway among 454 patients (2.2%) who underwent the surgical division of the accessory pathway. Our procedure involved the the endocardial approach with knife dissection and cryocoagulation. With the heart beating under normothermal cardiopulmonary bypass, delta wave disappearance was easily noted. Neither complete atrioventricular block nor recurrent conduction occurred. Cryoablation used by our endocardial surgical division, is a safe and accurate procedure.