What is the Maze Procedure?
The Maze Procedure is surgery performed to treat ATRIAL FIBRILLATION.
Atrial Fibrillation (also called AF or A Fib) is the most common arrhythmia found in adults. Characterized as irregular, disorganized, electrical activity of the upper chambers (atria) of the heart I it is present in close to 50% of all patients undergoing surgery for MITRAL VALVE disease, and 40% of patients with CONGESTIVE HEART FAILURE.
Affecting over 2 million Americans annually, this arrhythmia is on the raise as an increasingly larger fraction of the population reaches geriatric age, where it is rife.
Common symptoms of ATRIAL FIBRILLATION could include palpitations, a sudden fluttering or pounding in the chest. Sometimes, because the heart is not pumping adequately during AF, the symptoms may include dizziness, shortness of breath and feeling faint.
THE PROCEDURE
OPEN CHEST MAZE SURGERY means that the sternum is divided to allow access to the chest.
During this surgery, the heart is stopped and a heart-lung machine is used.
Scissors are used to open the pericardium to gain access to the heart and multiple energies are used during Open Chest Maze Surgery
During the 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.
Although the atrium is sewn back together, the erratic electrical paths remain severed so that no unwanted electrical impulse can cross the incision.
The result is what looks like a children's maze in which there is only one path that the electrical impulse can take from the SA node to the AV node.
The atrium can no longer fibrillate, and sinus rhythm (the normal rhythm of the heart) is restored.
Ninety percent of Maze surgeries are concomitant (done in conjunction) with other open chest surgery, such as CORONARY ARTERY BYPASS GRAFTING, MITRAL VALVE REPAIR and/or VALVE REPLACEMENT.
PREPARATION FOR SURGERY
Before traveling to Cyprus, as part of your surgery preparation we require detailed medical information in the form of a medical questionnaire, ECG, Pulmonary tests and blood work. In some cases an Angiogram is required. All of this information will allow the doctors that we work with to determine your eligibility for the procedure.
Your surgeon will give you specific instructions about any dietary changes or activity restrictions you should follow before surgery.
Tell your surgeon what medications you are taking, especially aspirin or an anticoagulant ("blood thinner"). Your surgeon will tell you if you should stop taking them. Also bring a complete list of your current medications (including over-the-counter drugs, vitamins and herbal supplements), allergies, your medical records and any health insurance information.
If you smoke, stop immediately to improve your blood flow and breathing.
If you develop a cold, fever or sore throat within a few days of your surgery, or have other questions or concerns, contact our offices immediately.
Ten days prior to your arrival in Cyprus, you will receive all the necessary pre operative instructions, to prepare yourself both physically and mentally for your chosen procedure.
Upon arriving in Cyprus, as part of the pre-surgery tests done at our partner hospitals you will again receive chest X-rays, blood tests, an electrocardiogram and a coronary angiogram, which is a special type of X-ray procedure that uses dye to visualize the arteries that feed your heart.
Your surgeon and anesthetist will also go through you medical and surgical issues with you. During this visit, your surgeon will discuss your procedure and answer any questions.
Getting Your House Ready For Surgery
It is also important to get your house ready for after you come home from the hospital. At first it will be harder for you to move around, so arrange your furniture and household items ahead of time to make it easier for you during your rehabilitation.
Remove all your throw rugs or anything on the floor that may cause you to trip.
Move phone and electrical cords close to the walls.
Move necessary personal items you need to reach to shelves and tables that are above your waist level.
Preparation for the hospital
Here are a few things to keep in mind as you pack and prepare for the hospital and recuperation:
Clothing
Getting dressed in the morning helps you feel better, so be sure to bring some comfortable clothing to the hospital:
Day Before Surgery
Your surgical nurse will provide you with these instructions the night before surgery:
The night before your surgery, you can eat a normal meal, but do not eat, drink or chew anything after 12 o'clock midnight. This includes gum, mints, water, etc.
Morning Of Surgery
On the day of your surgery, your designated Salus Patient Concierge along with a nurse may talk with you and your loved ones. They shall tell you what to expect. You will most likely feel a little nervous before surgery, so the SALUS team and the hospital staff will do all they can to answer your questions and help you relax.
Make sure all your medicines in their original containers with you to the hospital.
You will meet with the anesthesiologist who will talk to you about general anesthesia. This is a controlled sleep while the surgery is being done so you will not feel any pain or remember the surgery.
You should leave jewelry, watches, money and other valuables with the person who accompanies you or with our staff member who will place them in our safe.
Proceed with your routine morning care:
When it is time for you to go to surgery, your family/ companion will be asked to wait in the waiting area. Your doctor will talk to your family/ companion there after your surgery is done.
RECOVERY AFTER SURGERY
After surgery, the patient is moved to the Cardiac Surgical Intensive Care Unit where family members can visit the periodically.
Heart rate and blood pressure monitoring devices continuously monitor the patient for 12 to 24 hours. Medications that regulate circulation and blood pressure may be given through the I.V. (intravenously). A breathing tube (endotracheal tube) will stay in place until our surgical team is confident that the patient is awake and ready to breathe comfortably on his or her own. The patient may feel groggy and disoriented, and sites of incisions may be sore. Painkillers are provided as needed.
Patients usually stay in our partner hospitals for about one week or longer if necessary, after surgery. This time is much longer than what is normally necessary, however, it does give our surgeon adequate time to monitor post operative recovery. During this time, some tests will be done to assess and monitor the patient’s condition.
Hospital Discharge and Home Instructions
Your diet is slowly increased from ice chips to liquids to solid foods as your intestines start functioning.
Before leaving the hospital, our surgeon and staff will help you adjust to recovery in every way possible. You will receive specific instructions and precautions from your surgeon and nursing staff and they will show you safe techniques of simple activities like getting in and out of bed, bathing, going to the bathroom, managing steps at home and getting in and out of a car.
You will be able to leave the hospital when you are:
You will remain hospitalized for about 10 days while your heart is monitored and your vital signs are checked frequently.
LIFE AFTER SURGERY
These guidelines give you an overview of what you may expect as part of your care after you leave the hospital. Be sure to follow your doctor’s discharge instructions if they are different from what is listed here.
Your Activity
Arrhythmias are very common, particularly among older adults and in people who have diseases that affect their heart.