Overview
The Maze procedure is an open heart surgery to cure serious atrial fibrillation or arrhythmia. The procedure is costly and invasive, but has a 98% success rate. A few patients who undergo this procedure will need to continue taking medication, or have an implanted pacemaker after the surgery.
Detailed Description
This procedure can be performed in conjunction with other heart surgeries. There is also a less invasive variation, which you can discuss with your doctor.
The idea behind the Maze procedure is similar to that of the much-less-invasive catheter ablation. In both procedures, some heart tissue is scarred in order to keep electrical impulses on their desired pathway. The Maze procedure is for patients for whom medication, catheter ablation and cardioversion have not worked.
The cost of this procedure runs at around $60,000, and insurance does not always cover it, though it is a proven procedure. The operation itself takes about three hours. It takes almost as much recovery time as a heart transplant—four to 12 days in the hospital and six to eight weeks afterwards before resuming normal activities.
The Procedure
The initial stages of the procedure are similar to the heart transplant. The chest is shaved, if necessary, and sterilized with alcohol. The patient is given general anesthesia to fall asleep. A catheter is then threaded through the jugular vein to the pulmonary artery, which transports blood from the heart to the lungs. This catheter measures pressure, heart function and oxygen levels, and delivers medicine. The patient will also have tubes to help breathing, and to empty the bladder. An 11-12 inch incision is then made in the chest, and the breast bone is split in two so the doctor can access the heart. The patient will then be put on a heart-lung machine, which will perform the functions of the heart and lungs, pumping oxygenated blood through the body while the procedure is going on.
The doctor then makes several incisions in both of the atria. These incisions map out a “maze” for the electrical impulses to travel from the top to the bottom of the atria. The scars create a series of “dead ends,” and if the impulses try traveling down them, they find that they can’t go any further. This prevents the impulses from violating the prescribed pathway.
Thirty percent of patients experience temporary fibrillation in the first three months following the surgery. This is due to the swelling caused by the surgery, and is controllable with medication. Once the heart has healed completely, the fibrillation should stop.
Related Conditions
Aortic Valve Stenosis
Atrial Fibrillation
Last updated: 31-May-04
