What is Maze Surgery?
BDS (Bachelor of Dental Surgery), 6 years of experience
What is the meaning of Maze Surgery?
A surgical procedure done to treat atrial fibrillation is known as a Maze surgery or surgical ablation. Atrial fibrillation is a type of abnormal heart rhythm or heart arrhythmia. It occurs when the electrical signal responsible for the beating of the heart travels through the heart in a disorganized way. This causes a heartbeat that is irregular and too fast.
A person having atrial fibrillation has an increased risk of developing stroke (a condition in which the blood supply to the brain is interrupted) and heart failure (failure of the heart to pump sufficient blood to the rest of the body). Maze surgery is a major procedure that may have potential complications. It is performed only when the lesser invasive options fail to treat atrial fibrillation.
In this article, we will be discussing in detail maze surgery.
- What are the different types of Maze Surgeries?
- What is the purpose of Maze Surgery?
- What are the symptoms that indicate the need for a Maze Surgery?
- What is the diagnostic procedure before a Maze Surgery?
- How to prepare for Maze Surgery?
- What is the procedure for Maze Surgery?
- How to care after a Maze Surgery?
- What are the risks of Maze Surgery?
- What is the cost of Maze Surgery in India?
What are the different types of Maze Surgeries?
The different types of maze surgeries include:
Full maze:
- This is a type of open-heart surgery.
- It is generally performed when the patient requires an open-heart surgery for another type of heart condition, like heart valve surgery. ( Know more about- What is Aortic Valve Surgery? )
Mini-maze:
- This is a minimally-invasive type of maze surgery.
- The surgeon makes smaller cuts or incisions to place an endoscope (a long, thin tube with a camera on one end) and other surgical instruments to make cuts in the heart muscle.
- An individual with no other heart condition besides atrial fibrillation is a good candidate for mini-maze surgery. ( Know more about- What is Mitral Valve Surgery? )
Hybrid maze:
- A combination of the mini-maze procedure and catheter ablation (it is a minimally-invasive procedure that uses heat, cold or laser energy to treat irregular heart rhythms or heart arrhythmias) done to access the inside of the heart is known as a hybrid maze. ( Know more about- What is Cardiac Catheterization? )
- The cardiac ablation treats the inside of the heart, and the maze surgery treats the outside of the heart.
What is the purpose of Maze Surgery?
A maze procedure is usually recommended to treat symptomatic cases of atrial fibrillation. Maze surgery is preferred by the doctor only after the other treatment options having lesser risk of complications have proved to be ineffective.
A maze procedure is generally recommended when:
- Medications cannot be tolerated by the patient, or medications have been ineffective in treating atrial fibrillation
- The patient is unable to take blood-thinners or anticoagulant medications like warfarin
- The patient has had a stroke (the blood supply to the brain has stopped) or has a high risk of having a stroke
What are the symptoms that indicate the need for a Maze Surgery?
The following symptoms may indicate the need for atrial fibrillation:
- Shortness of breath
- Chest pain ( Know more about- What are the Home remedies for chest pain? )
- Fatigue
- Weakness
- Confusion ( Know more about- What is Brain Injury? )
- Dizziness
- Heart palpitations (skipped heartbeat or additional heartbeat)
- Blood clot formation
- Stroke ( Know more about- What is the Difference between Brain Stroke and Heart Attack? )
What is the diagnostic procedure before a Maze Surgery?
- Physical examination: The doctor will physically examine the patient and look for symptoms of atrial fibrillation. The patient’s medical history and family history are also noted.
- Blood tests and urine tests: These tests are done to check for medical conditions, like thyroid problems or the presence of any substances in the patient’s blood or urine that may be causing atrial fibrillation.
- Chest x-ray: The chest x-ray helps the doctor to evaluate the condition of the patient’s heart and lungs.
- Stress test: This test is done to evaluate the response of the patient while performing certain physical exercises.
- Electrocardiogram (ECG): This test helps in determining the electrical activity of the heart.
- Holter monitor: This is a type of portable ECG that is worn by the patient for 24 hours. It helps the doctor in obtaining the electrical activity of the heart for those 24 hours.
- Event recorder: This is also a type of portable ECG that monitor’s the heart activity of the patient over a period of a few weeks to months. The patient needs to press a button to activate the monitor, whenever he/she faces symptoms of fast heartbeats.
- Echocardiogram: Sound waves are used in this test to obtain the images of the heart in motion. ( Know more about- What is Echocardiography? )
- Trans-esophageal Echocardiography: A thin tube with a transducer is passed through the throat into the esophagus (food pipe) and sound waves are used to obtain detailed images of the heart.
How to prepare for Maze Surgery?
- Answer all your doctor’s questions about any medical conditions that you may be having.
- Tell your doctor if you are taking any medications, herbs, or supplements.
- If you are currently suffering from any allergies, inform your doctor about the same.
- Lose any excess weight that you may be having before the surgery by exercising and consuming a healthy diet.
- You may be instructed to stop taking blood-thinners like warfarin and aspirin a few days before the procedure.
- Stop smoking at least a couple of days before the procedure.
- You will be told to avoid eating or drinking anything after midnight, the day before the procedure.
What is the procedure for Maze Surgery?
The procedure is usually performed under general anesthesia (the patient is put to sleep during the procedure).
The maze procedure may be performed in one of the following ways:
Mini-maze surgery:
- The surgeon makes small keyhole incisions or cuts in the chest area.
- An endoscope (a thin, lighted instrument with a camera on one end) and some special surgical instruments are inserted through these incisions.
- The surgeon can view the inside of the chest while performing the surgery.
- Heat or cold energy is used to make scar tissue on the heart.
- This procedure is performed while the heart is still beating.
- The incisions are closed using sutures (stitches).
- The procedure has a quicker recovery and is less painful than open surgery.
- The procedure may also be performed as a robotic-assisted surgery, where robotic arms are controlled by the surgeon through the monitor to perform the procedure.
Open-heart surgery:
- When a valve or bypass surgery is needed for heart disease and the patient is also suffering from atrial fibrillation, the surgeon may perform a maze surgery during open-heart surgery. ( Know more about- What is Heart Bypass Surgery? )
- A large incision is made by the surgeon in front of the chest and separates the breastbone.
- The heart is stopped to perform this surgery.
- The surgeon connects you to a heart-lung bypass machine, which does the work of the heart and lungs during the surgery. ( Know more about- What is Pacemaker Surgery? )
- Heat or cold energy is used to make scar lines in the upper chambers of the heart, known as the right and left atria.
- The patient’s heart-lung bypass machine is then removed, the breastbone is wired back together, and the incision is closed using sutures.
How to care after a Maze Surgery?
- It is normal to have some soreness after the procedure.
- A tube may be placed in your throat to help you breathe. The tube is usually removed two days after the surgery.
- A tube may be placed in the chest region to drain the extra fluids. The tube is normally removed two days after the procedure.
- The vital signs of the patient are monitored continuously in the hospital.
- You will be taught breathing exercises to help in the removal of the fluids that get collected in the lungs during the surgery.
- The doctor may prescribe pain-relieving medications.
- The patient will initially be on a liquid diet, and gradually progress to normal food.
- You will stay in the hospital for two to three days after a minimally-invasive procedure, and for five to ten days after open-heart surgery.
- Avoid heavy lifting for a few weeks after the surgery.
- The sutures are removed by the surgeon 7 to 10 days after the procedure.
- Follow all the instructions given by the doctor regarding medications, diet, exercise, wound care, and driving.
- Complete recovery may take two to three months.
What are the risks of Maze Surgery?
The complications associated with a maze surgery include:
- Bleeding
- Infection
- Allergic reaction to anesthetic agents
- Blood clot formation
- Heart attack
- Kidney failure (buildup of fluid and waste in the body due to the deterioration of the function of the kidney)
- Stroke
- Arrhythmias ( Know more about- What are the Arrhythmias of the heart ? )
- Requirement for a permanent pacemaker (a device that uses electrical pulses to help the heart return to its normal heartbeat in case of an arrhythmia)
What is the cost of Maze Surgery in India?
The total cost of maze surgery in India can range from around INR 2,50,000 to INR 4,00,000. However, many prominent hospital doctors in India specialize in maze surgery. But the cost varies across different hospitals.
If you are coming from abroad, apart from the cost of maze surgery, there will be an additional cost of living in a hotel and the cost of local travel. After the procedure, the patient is kept for seven days in the hospital and fourteen days in the hotel for recovery. So, the total cost of maze surgery in India comes from a total of INR 3,25,000 to INR 5,20,000.
We hope that we could answer all your questions regarding maze surgery through this article.
If you need more information about maze surgery, you can contact a Cardiologist.
We only aim to provide you with information through this article. We do not recommend any medication or treatment to anyone. Only a qualified doctor can give you the best advice and correct treatment plan.
