The Journal of Thoracic and Cardiovascular Surgery, Vol 93, 913-918, Copyright © 1987 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Surgical therapy for supraventricular tachycardia, a potentially curable disorder
DC Johnson, GR Nunn, DA Richards, JB Uther and DL Ross
One hundred fifty-six patients underwent investigation and operation for
supraventricular tachycardia: 145 had attempts at curative operations and
11 had His bundle section. Operative mortality was 0.68% and there were no
late deaths among patients having curative operations. One patient died
suddenly 1 year after His bundle section. All patients underwent
electrophysiologic study before discharge and 6 months postoperatively. A
satisfactory result, without supraventricular tachycardia and without
medication, was achieved in 96.5% of all patients. Ninety-three percent
have no supraventricular tachycardia and no demonstrable reentrant pathway
at electrophysiologic study. All free wall accessory atrioventricular
connections were divided and 97.7% of the patients were cured. Ninety
percent of patients with posterior septal accessory atrioventricular
connections had a satisfactory result, with cure demonstrated at late
electrophysiologic study in 84%. Fifteen patients with atrioventricular
junctional reentrant tachycardia were all cured, with preservation of
normal atrioventricular conduction. Eight (88%) of nine patients with right
atrial tachycardia were cured, and two patients with nodoventricular fibers
and one patient with incessant atrioventricular junctional tachycardia had
satisfactory results. Supraventricular tachycardia is now a potentially
curable disorder when managed by low risk surgical procedures that offer a
high cure rate.
