ABSTRACT
A case of surgical treatment for reentrant atrioventricular tachycardia in a 7 months old child is reported. Episodes of tachycardia were repetitive and long-lasting, often leading to signs of hemodynamic impairement, and were not controlled by antiarrhythmic drugs. The electrophysiologic study showed a circus-movement tachycardia utilizing a concealed accessory pathway located at the anterior septal aspect of tricuspid anulus. The child underwent successful surgical treatment by the endocardial technique. Few minutes after weaning from extracorporeal circulation, developed T wave inversion followed by acute right ventricular dysfunction and ventricular fibrillation. Others ischemic like episodes, maybe as a result of coronary artery spasm, occurring in the next 6 hours were successfully treated with isosorbide dinitrate. At 18 months follow-up, the child is free of tachycardia and has normal atrioventricular conduction.
