Cryosurgical ablation of right parietal and septal accessory atrioventricular connections without the use of extracorporeal circulation. A new surgical technique.

A new technique for definitive surgical treatment of the preexcitation syndrome without the use of extracorporeal circulation has been elaborated and clinically used in 25 patients with Wolff-Parkinson-White syndrome. Seventeen patients had right parietal accessory atrioventricular connections and eight had septal connections. In patients with right-sided connections the fat pad in the coronary sulcus was dissected with an ultrasonic scalpel. Ablation of accessory atrioventricular connections was obtained by applying local cryothermia. The evidence of preexcitation and arrhythmias disappeared in all patients. All patients recovered without surgical complications and there were no deaths. The described technique offers considerable advantages over previous surgical methods in selected patients with Wolff-Parkinson-White syndrome.