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Cardiovascular Institute

Treatment

Maze Ablation Procedure | Minimally Invasive Maze Procedure

Maze Ablation Procedure

In recent years, surgical methods of treating AF have continued to develop. Since 2001, more than 40,000 patients have had the Maze procedure. It has been proven effective for a wide range of AF patients, even some with chronic AF. The surgeon will use instruments to identify the faulty electrical sites in your heart that are causing it to beat irregularly and too fast. Then the surgeon will use an instrument with a heat source to create precise scars, or ablations, on those spots. These scars will block the abnormal electrical impulses that cause AF. This can help return your heart to a normal rhythm.

Keep in mind that the Maze procedure is also an invasive procedure requiring open heart (concomitant) surgery and often a heart-lung bypass. You and your doctor may want to consider this option if you have AF and need open heart surgery for another reason, such as bypass surgery or a valve repair or replacement procedure. During this surgery, the surgeon will also create the necessary ablations that can block the abnormal electrical impulses causing your AF. Additionally, many surgeons will also remove or close off a small cul-de-sac-shaped pouch on the heart (the left atrial appendage), believed to be the primary site where stroke-causing blood clots form during AF.
 

 

 

Minimally Invasive Maze Procedure

For people who suffer from AF, but are otherwise fairly healthy, a minimally invasive Maze procedure (or Mini Maze) has continued to develop over the last several years.

For the Mini Maze, the surgeon will access your heart by making three small incisions between your ribs, through which a tiny camera and video guided instruments are inserted. As with the open heart Maze procedure, the surgeon will identify the faulty areas where abnormal electrical signals are getting through, create precise scars (ablations) to block those signals, and remove or close off the left atrial appendage, where stroke-causing blood clots often form.

The Mini Maze involves:

  • Bilateral Pulmonary Vein Isolation
  • Ablation of pulmonary ganglionic cells to reduce the recurrence of afib
  • Removal of left atrial appendage to reduce the risk of stroke with afib

A less invasive version of the traditional open chest Maze procedure, the Mini Maze technique is designed to be performed as a stand-alone operation for atrial fibrillation patients who do not have other cardiac disorders requiring surgery. This procedure requires a small chest incision near the breast and two small incisions on the chest wall for insertion of video camera and Mini Maze instruments. The Mini Maze instrument is a clamp that is placed on the atria. It emits bipolar radio frequency energy to isolate and ablate the region of the heart tissue where the arrhythmias originate. Following ablation in the atria, the surgeon also removes a small structure called the left atrial appendage, which is implicated in cardio-embolic stroke in patients with atrial fibrillation.

Features:

  • Only three hours to perform the procedure
  • Shorter length of stays: two days of hospitalization
  • Less pain and easier recovery
  • Effective treatment in eliminating atrial fibrillation and reduces the risk of stroke
  • May be able to eliminate the need for coumadin
  • Near 85% success rate in patients with recent onset/paroxysmal AF

Benefits and Surgical Risks of the Mini Maze Operation

The Mini Maze operation is the first surgical treatment that can safely, easily and reliably eliminate atrial fibrillation. It helps patients avoid lifelong drug therapy and reduces the high risk of stroke and other complications that are associated with atrial fibrillation. The Mini Maze procedure carries the same risks as other forms of heart surgery, including bleeding at the wound site, heartbeat irregularities and stroke.  


 

 

 

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