Mini Maze Procedure

Not everyone with atrial fibrillation needs to have open heart surgery. In fact, about one-third of afib patients don't have any other heart issues. For most, the open chest procedure just doesn't make sense, especially due to the long and difficult recovery period.

Fortunately, if you have just atrial fibrillation and no heart valve issues, there is a minimally-invasive version of the maze procedure. It's called the mini maze procedure. It evolved from the Cox Maze III procedure, which is a "cut-and-sew" procedure, and is performed on a beating heart without opening the chest.

This procedure is done by a cardiothoracic surgeon. It takes only a few hours, and doesn't require the large incisions in the sternum that are necessary for open-heart surgery. Thus, recovery time is much shorter and easier, and most patients are afib-free afterwards. The mini maze procedure offers a way to stop the irregular heartbeats and heart palpitations without the long and difficult recovery for open-heart surgery. It is a potential atrial fibrillation cure.

While patients with paroxysmal atrial fibrillation have been considered the best candidates for the mini maze procedure, recent enhancements have also yielded success with persistent and longstanding persistent atrial fibrillation, sometimes referred to as chronic or permanent atrial fibrillation.

To get to the heart, the surgeon makes three or four small incisions on each side of the chest, and through these incisions places surgical instruments, an ablation device, and a thoracoscope. The thoracoscope (endoscope) is a camera and direct vision device that allows the surgeon to see the heart inside of the chest.

A surgical ablation energy source is used to create a conduction block that isolates the pulmonary veins and stops the chaotic electrical signals from disrupting the heart. While in there, the surgeon treats the Ligament of Marshall and nerve bundles that are called the ganglionic plexi, and removes or clamps off the left atrial appendage to reduce the risk of blood clots and stroke. Recently, outcomes have improved for those with persistent and longstanding persistent atrial fibrillation. 

If you are interested in learning more about the mini-maze procedure and to find out if you might be a candidate contact Saint Vincent Cardiovascular Surgery at 814-456-9197.