The Maze procedure is a surgical procedure performed to treat atrial fibrillation, a condition where your heart beats abnormally. Normally, your heart contracts and relaxes to a regular beat. Certain cells in your heart make electric signals that cause the heart to contract and pump blood.
In atrial fibrillation (A-Fib), the heart’s two small upper chambers (atria) of the heart don’t beat the way they should. Instead of beating in a normal pattern, the atria beat irregularly and too fast, quivering like a bowl of jello. It’s important for the heart to pump properly so your body gets the oxygen and food it needs.
You can live with AFib, but it can lead to other rhythm problems, chronic fatigue, heart failure, or even stroke. You’ll need a doctor to help you control the problem and the Maze Procedure is the latest breakthrough to help eliminate A-Fib or drastically reduce the symptoms of A-Fib and the illnesses and diseases it can lead to.
During the Maze procedure, a number of incisions are made on the left and right atrium to form scar tissue, which does not conduct electricity and disrupts the path of abnormal electrical impulses.
The scar tissue also prevents erratic electrical signals from recurring. After the incisions are made, the atrium is sewn together to allow it to hold blood and contract to push blood into the ventricle.
Atrial Fibrillation Maze has become a popular and increasingly viable treatment option for individuals with atrial fibrillation because it provides candidates with a permanent solution. Those who elect to have the Maze procedure can expect close to a 90% success rate, which is significantly better than the aging catheter ablation procedure.
The maze is separated into two different surgical techniques – the Mini-Maze and the Full Maze procedure. A cardiac surgeon will help you decide which is best for your condition.
The Mini-Maze, short for minimally-invasive, is used for the treatment of paroxysmal A-fib. The surgeon accesses the heart through small incisions under the arm and between the ribs, where he uses an ablation device to transmit an energy source to scar (ablate) the areas where the irregular signal starts.
The newly formed scar tissue will prevent abnormal electrical impulses and will interrupt the transmission of the abnormal signals that cause A-fib, allowing the heart to beat normally.
The surgeon also uses a probe to map the autonomic nerve bodies on the heart that cause abnormal electrical signals in the heart, and an energy source from the probe ablates these nerve bodies, further extinguishing the sources of the erratic heartbeats from the atria. This is actually a proactive portion of the procedure and is exactly why MAZE is so successful.
Lastly, the surgeon will remove the left atrial appendage, a finger-like structure or pouch that is believed to be the primary location where blood clots form during A-fib, and also where 90% of the potentially stroke-causing clots found in the heart in association with A-fib are located.
By removing this, stroke risk is greatly reduced. The 2-3 hour procedure is performed without stopping the heart or using the heart-lung machine, resulting in a highly effective procedure that is simpler and safer for the patient, and one which only requires a couple of days in the hospital. Most patients are able to return to normal activities in 1-2 weeks.
The Full-Maze procedure is for candidates who are in persistent A-fib, and for those who also need heart surgery for coronary artery disease or valve disease.
The chest is opened through a chest incision called a sternotomy, and it involves a full Mini-Maze procedure plus more extensive lesions to ablate and scar the extra pathways involved in persistent A-fib and even atrial flutter.
Additionally, the procedure uses a combination of surgical incisions and an energy source to ablate (scar) the problem cells and create scar tissue, creating a “maze” in the heart.
Afterward, the electrical impulse of the heart can only travel down one pathway thus restoring a normal rhythm in the heart.
The left atrial appendage is removed just as it is in the Mini-Maze. Unlike the Mini-Maze, however, the Full-Maze takes an hour or two longer, and perhaps a day longer in the hospital. Patients who receive a Full-Maze procedure generally make a full recovery after 4-5 weeks.