If you suffer from atrial fibrillation (known as Afib) and medications have been unable to control the condition, your physician may recommend Maze surgery. This is an operation during which your surgeon ablates the atria (two upper chambers of your heart) and creates scar tissue across their surface. The purpose of doing this is to create a pathway for erratic electrical signals that are causing your atria to flutter, rather than contract normally. This pathway forces the signals to travel along a defined route.
There are a few ways to perform the operation, depending on the circumstances. In some cases, it is done through open-heart surgery. This requires the sternum to be split and retracted in order to give the doctor enough room to create the scar tissue. In most cases, however, Maze surgery can be accomplished using minimally invasive techniques. The surface of the atria can be ablated without splitting the sternum.
This article will describe the preparatory steps leading up to the Maze procedure. The following steps help minimize the likelihood of complications during and after the operation.
Two Weeks Prior: Getting Up To Speed
Your doctor will want to schedule a preliminary appointment with you to provide details regarding what you can expect during surgery and recovery. During the meeting, you’ll have an opportunity to meet the members of the surgical team. These include the surgeon, cardiologist, and anesthesiologist. Your doctor will explain the recovery process, both in the hospital immediately following Maze surgery and at home.
One Week Prior: Making Arrangements
During the week leading up to your operation, ask a friend or family member to remain available to drive you home after you recover. Also, if you are taking any medications, including anticoagulants or dietary supplements, inform your physician. He or she may suggest that you stop taking them until after the operation.
Your surgeon may use a contrast dye to illuminate the blood vessels prior to ablating the atria. This is normally done for open-heart procedures, rather than minimally invasive Maze surgery. If you are undergoing open-heart Maze, inform your doctor if you have an allergic reaction to shellfish. This same reaction may be produced by the contrast dye.
Ask your doctor whether you’ll need to have any diagnostic tests done before surgery. He or she may want to order an electrocardiogram, chest x-rays, a CT scan, and other tests to ensure your condition remains suitable for the procedure.
The Night Before
You’ll be expected to stop eating and drinking by midnight of the evening prior to surgery. Your doctor may also provide an enema that will help empty your bowels. If you eat anything during the morning or day of the operation, inform your doctor.
The Day Of The Operation
You will be admitted to the hospital on the day the procedure is scheduled. Avoid taking any pills before the operation unless your doctor says doing so is acceptable. To prepare you for the Maze procedure, your chest will be shaved and cleaned. You will be connected to a heart monitor so your health care team can observe your heart rhythm. Finally, the anesthesiologist will administer a general anesthesia to put you to sleep for the operation.
Unless complications develop, creating the scar tissue usually requires less than an hour. Combined with the time needed to access your heart, isolate key blood vessels, and close the wound afterward, you may be in the operating room for up to three hours. Once your doctor is certain there is no bleeding, the wound is closed and you are moved into the intensive care unit to begin your recovery.
Minimally invasive Maze surgery requires far less recovery time than an open-chest operation. If you live with atrial fibrillation, ask your physician whether you are a suitable candidate for this procedure.