A Case of Coronary Artery Bypass Grafting in a Patient with Wolff-Parkinson-White Syndrome

(Department of Cardiovascular Surgery, International Medical Center of Japan, Tokyo, Japan and Department of Surgery, Sakakibara Heart Institute*, Fuchu, Japan)

Kayo Sugiyama Shigeru Hosaka Toshitaka Kashima
Togo Norimatsu Naomi Ozawa* Samu Akita
Tadashi Omoto Masato Kume Sosuke Kimura
A 54-year-old man with unstable angina and Wolff-Parkinson-White (WPW) syndrome was admitted. Coronary angiography showed 90% stenosis of the left main trunk and 75% stenosis of the obtuse marginal branch. Coronary artery bypass grafting under cardioplegic arrest was done emergently. The left internal mammary artery graft was anastmosed to the left anterior descending artery, and a saphenous vein graft was used as a sequential bypass graft to the high lateral branch and obtuse marginal branch. Immediately after weaning from cardiopulmonary bypass, paroxysmal supraventricular tachycardia (PSVT) requiring electrical cardioversion was occurred, and catheter ablation was performed on the first postoperative day. There are controversus concerning the strategies of surgical treatment for unstable angina concomitant with WPW syndrome. Coronary bypass operation may trigger PSVT in patients with WPW syndrome. The optimal timing of perioperative catheter ablation needs further discussion.
@Jpn. J. Cardiovasc. Surg. 35: 37-40 (2006)