Surgical treatment of supraventricular tachycardia in infants and children.

The technique, indications and results of surgical division of accessory atrioventricular connections in 10 infants and children with drug-resistant supraventricular tachycardia are described. The patients ranged in age from 6 months to 15 years. Four patients had associated congenital heart disease. Division of accessory connections were performed on free wall pathways in nine patients (seven right atrial, two left atrial) and on a septal pathway in one patient. Four patients had both anterograde and retrograde conduction over the accessory connection (manifest Wolff-Parkinson-White conduction) whereas six had only retrograde conduction (concealed Wolff-Parkinson-White conduction). The manifst Wolff-Parkinson-White conduction was abolished by surgical division in all four patients. In 8 of the 10 patients the procedure stopped the attacks of paroxysmal supraventricular tachycardia for follow-up periods ranging from 9 months to 3 1/2 years; no patient receives medication to date.