What Is Maze Surgery?

Maze surgery, or surgical ablation, is a procedure commonly recommended to treat an irregular heartbeat (atrial fibrillation) when other methods such as medication, cardioversion therapy (electric reset), or catheter/cardiac ablation have not been successful.

What Does "Maze" Stand For?

Maze is not an abbreviation, rather, it describes the intricately detailed maze of scar tissue that forms as a result of this corrective surgery.

The Maze Procedure

Our doctors create a series of lesions on the part of your heart that controls your heartbeat. After the surgery, scar tissue forms over these abrasions to stop the irregular signals and regulate your heartbeat.

Depending on your doctor’s recommendations, Maze may be performed with a combination of cryoablation (freezing) and radiofrequency ablation (heat).

 

How Long Does It Take for Maze Surgery to Correct an Irregular Heartbeat?

Most patients see reduced symptoms within six to eight weeks and a fully corrected heartbeat within three to six months.

Maze Surgery vs. Catheter/Cardiac Ablation

One of the easiest ways to understand the difference between the two procedures is that catheter/cardiac ablation destroys the tissue that causes the arrhythmia. Maze surgery, on the other hand, redirects the inconsistent electrical impulses (via scar tissue) to correct the arrhythmia.

Our specialists consider catheter/cardiac ablation to be less invasive because we insert a thin catheter into your heart. We then use heat (radiofrequency) or cold energy (called cryoablation) to kill damaged heart tissues that are causing problems.

The Maze procedure is much more complex. It is typically performed as an open-heart surgery in conjunction with other operations that treat coexisting heart conditions like valve disease or coronary artery disease.

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What to Expect During Maze Surgery

We may perform Maze surgery using several methods with different degrees of invasiveness. We will discuss every detail with you to make sure you feel comfortable with each step of the procedure.

Traditional Maze Surgery

Traditional Maze surgery is an open-heart operation. If you and our specialist select this surgery, the treatment team will give you anesthesia before the surgery begins to help you sleep deeply and painlessly during the operation. You will not remember the operation. 

Procedure Length

The operation usually takes two to four hours. You will be connected to a heart-lung machine to keep your body functional during the operation.

We will make an incision (cut) down the middle of your chest or right side of chest to access your heart.  Then we use a scalpel to make several calculated cuts in a maze-like pattern in your heart's right and left atria.

Scar tissue that forms around the surgical cuts after the surgery acts as a barrier to keep the electrical signals on their new path. Then we sew them back together.

We also use alternative methods such as radiofrequency, ultrasound or cryothermy (freezing) to destroy small areas of tissue.

When the surgery is complete, our team will remove the heart-lung machine, repair your breastbone with wire, and close the incision on your skin.

You will wake up a few hours after your procedure.

 

MiniMaze Surgery

MiniMaze is an option to consider for patients who do not need open-heart surgery for additional heart-related procedures. The incision site is the only difference between the two procedures — we make a small cut between your ribs instead of your heart. All other aspects of this procedure are identical to traditional Maze surgery.

After Maze Surgery

You will be transferred to the intensive care unit (ICU) for one to two days before moving to a regular room. Our recovery team will closely monitor your vital signs and medication. You may have a breathing tube or a tube in your chest to help drain any excess fluid.

Your doctor may prescribe a blood-thinning or antiarrhythmic medication for a limited period following the surgery. 

Maze Procedure Recovery Time

Your recovery time will depend on which Maze procedure you have. Most patients are released from the hospital within four days after minimally invasive surgery or five to seven days for combined/open-heart surgery.

It will take about three to eight weeks to go back to your normal, daily activities.

It’s common to experience some episodes of atrial fibrillation during your recovery time. As your heart heals, these episodes will lessen. 

Follow-Up Care For Maze Surgery

Incision Care

Your incision should be cleansed daily with a gentle soap and water. Keep it dry until your stitches or sutures are removed at your follow-up visit. 

Call your doctor immediately if you notice any discharge, increased pain, or redness at the incision site.  

Medication

Your doctor will prescribe you a combination of medications to help you recover and manage the pain after surgery. This may include:

  • antiarrhythmic medications, which will depend on your heart’s rhythm post-surgery,
  • blood thinners like Coumadin or novel oral anticoagulants (NOACS), and
  • narcotics or other pain medications to only use as needed. For mild discomfort and pain, take Tylenol.

Check in with your electrophysiologist within four to six weeks to adjust your medication and discuss further care. You will be on blood thinners for the first three months and may continue this medication under the advisement of your electrophysiologist.

Ongoing Care 

You may return home with a 30-day, wearable EKG sensor to monitor your heart beat.

You will be scheduled for a follow-up visit two weeks after your surgery. At this appointment, your doctor will remove your stitches. You will also have a chest x-ray, EKG, and receive additional lab testing.

Most patients begin cardiac rehabilitation within two weeks of surgery. This medically supervised program helps your heart become healthy and strong after surgery.

We also recommend the following heart-healthy lifestyle changes, which can have a positive impact on your overall health.

  • No smoking.
  • Eat a healthy, well-balanced diet.
  • Exercise at least 150 minutes each week. Walking or any other type of light physical activity can help decrease the incidence of atrial fibrillation episodes.

Maze Procedure Success Rate

Maze procedures are highly successful. Many patients have no recurring issues, but some patients still need medication or a pacemaker to control their atrial fibrillation.

If your symptoms return after a Maze procedure, you could choose to undergo either a catheter/cardiac ablation or another treatment.

Next Steps

If you think you may be a candidate for Maze surgery or would like more information, please call 801-585-7676.

Your primary care doctor may also refer you to our office or help you schedule an appointment. We will need to conduct an echocardiogram and possibly some other tests before we move forward with Maze surgery.