A 21-year-old man with atrioventricular[AV] reentry tachycardia secondary to concealed accessory AV connection underwent surgical division of two accessory pathways following failure of radiofrequency catheter ablation. pathways were located in the left free wall area.Before cardiopulmonary bypass, the epicardial mapping confirmed the existence and localization of two accessory pathways. The patient was approached through a left atriotomy with a dissection of the left free wall area beginning with an internal mapping was carried out after separation from cardiopulmonary bypass to confirm the absence of retrograde conduction of accessory pathway. Five weeks after surgery, the electrophysiololgic study demonstrated no retrograde conduction through two accessory pathways.