Wolff-Parkinson-White syndrome associated with a coronary sinus diverticulum: ablative surgical approach

This report concerns a patient with drug refractory supraventricular tachycardia due to the Wolff-Parkinson-White syndrome in association with a coronary sinus diverticulum. Division of the anomalous bypass tract was initially performed by an endocardial approach together with circumferential dissection of the neck of the diverticulum. This procedure failed to ablate the bypass tract that was only successfully divided when the superficial wall of the diverticulum was excised. This case illustrates the close association that exists between an anomalous atrioventricular bypass tract and a coronary sinus diverticulum, and the importance of dividing the superficial wall of the diverticulum as an integral part of the ablative procedure.