A maze procedure is one option for treating atrial fibrillation (AF or AFib) that is used to control the irregular heartbeat and restore the normal rhythm of the heart. Doctors may recommend the maze procedure to those for whom atrial fibrillation isn't controlled by medication, or who can't take medication or anticoagulants, and who also require heart surgery. While conducting the surgery, doctors make tiny cuts in the heart muscle that scar as they heal. These cuts that the surgeon makes in the atria prevent the spread of irregular electrical signals (through the heart muscle causing AF) by giving the heart new pathways for them.
Not everyone is a good
candidate for maze procedure. It is only if you meet your surgeon’s criteria
that you’ll be sent for a pre-surgery evaluation that typically involves
several tests, including complete physical, electrocardiogram (ECG),
echocardiogram, stress test or nuclear stress test, Holter Monitor, computed
tomography (CT) scan, transesophogeal echocardiography (TEE), and blood work.
The test results will decide if you can move forward with the maze procedure.
If you become eligible, you will be given pre-surgery instructions which you’ll
need to follow.
If medicine isn’t proving to
be useful in managing and controlling your AFib, it’s advisable that you
discuss other treatment options like the surgical ablation maze procedure, the
mini maze procedure, or catheter ablation with your doctor. Weigh the pros and
cons of every treatment option, and accordingly decide your choice of
treatment.
Here are a few things we’d
like to discuss today about the maze procedure which you may not be aware of:
1.
The maze
procedure has actually been around for decades with a very high success rate of
more than 96 percent of patients remaining free of afib even 10 years after
surgery. Furthermore, the procedure has evolved over time, in terms of the fact
that the procedure is a complex open heart surgery involving cutting and sewing
of the heart muscle, but now nothing of that is necessary as the procedure uses
an energy source, such as laser, to make tiny cuts in the heart muscle.
2.
There are
two basic versions of a maze procedure, a full maze procedure that involves
opening the chest, making it the most invasive version, and the other type of
surgery is a mini-maze, which is a minimally invasive procedure that uses an
energy source to cut the heart muscle, and doesn’t require opening the chest.
Mini-maze procedure is typically recommended for people with intermittent
(paroxysmal) afib, and sometimes also for people with long-standing
(persistent) afib. There are still high chances that the surgery will be
successful (for people with persistent AF).
3.
Now let us
talk about the latest development in the maze procedure that it can be combined
with a catheter ablation, it’s called a hybrid
maze procedure. In the hybrid procedure, the catheter ablation takes care
of the inside of the heart and the maze surgery takes care of the outside. This
is still relatively new and not all hospitals or heart centers can perform this
procedure. This procedure has proven to be effective for people with difficult
to treat persistent afib. Research is still underway with regards to identifying
the safest and the most effective way to carry out this procedure.
4.
After a
mini-maze procedure, it won’t be long before you can get back to your normal
routine, in a matter of just a few days. With a full-maze procedure, full
recovery can take 8 to 12 weeks because it’s open heart surgery. You’ll have to
stay in the hospital and ICU for a longer length of time than for a mini-maze.
After the procedure, your doctor will prescribe a cardiac rehab program for you
to recover safely and quickly.
5.
Most people
who undergo maze surgery will have short episodes of AF during recovery, mainly
due to swelling in the heart muscle. With time as you recover and the swelling
goes away, you won’t any further experience these bouts of AFib. It is
important that you take the medicines prescribed by the doctor to control your
heart rhythm and to prevent formation of blood clots. These aren’t long-term
medicines, you’ll have to take them for just about three months.
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