QUESTIONS AND ANSWERS

Question: What is the Mini-Maze?

Answer: The Mini-Maze is a minimally invasive cardiac procedure that has been found to be a potentially curative therapy for atrial fibrillation. Lesion lines are created to block the abnormal electrical impulses that cause irregular heartbeat. Unlike other heart surgeries, the Mini-Maze does not require a sternotomy (cutting the breast bone). The Mini-Maze takes advantage of small incisions located between the ribs to access the beating heart. No heart lung machine is typically required.
Doctors make small incisions on both sides of the chest. Each side is done one at a time. The surgeon inserts a small camera and a device between the ribs. The device is placed on the atrium above the pulmonary veins, and the tissue is heated to create a lesion. The lesion prevents irregular electrical impulses and allows the heart to beat normally. This process is then repeated on the other side. This procedure usually takes a few hours.


Question: What is the difference between the Mini-Maze and the Modified Maze?

Answer: A Mini-Maze is a procedure where the chest is kept closed. A modified maze is a surgical approach that takes advantage of the chest being open to correct another heart problem, e.g., heart valve repair, coronary bypass, congenital defects, etc…. These other procedures typically require a heart lung machine to circulate the blood while the heart is being repaired. As with the Mini-Maze, the modified maze creates lesions to block the abnormal electrical impulses that cause an irregular beat.
The modified maze requires a sternotomy (cutting the breast bone) to access the heart. The device is placed on the atrium above the pulmonary veins, and the tissue is heated to create a lesion. The lesion prevents irregular electrical impulses and allows the heart to beat normally. This process is then repeated until all the sources of abnormal electrical impulses are blocked. It takes a few minutes to create the necessary set of lesions with the device.


Question: What is the benefit of having a Mini-Maze or Modified Maze procedure?

Answer: Some patients do not tolerate or achieve desired results from drug therapies. The Maze procedures provide a curative approach to Atrial fibrillation, and minimize the risk of stroke.


Question: What risks are associated with the Maze procedures?

Answer: As with any surgery or general anesthesia you are at risk for unplanned problems. These should be discussed with your doctor prior to surgery.


Question: What is the difference between the Mini-Maze and catheter ablation?

Answer: The Mini-Maze procedure is performed in an operating room and a catheter based procedure is performed in the Cardiac Catheterization/Electrophysiology Lab. Catheter ablation involves inserting sheaths (tubes) into the groin (femoral vein) so that thin flexible wires can be maneuvered up the vein into the heart. A needle must be used to advance the wire from the right upper chamber to the left upper chamber (transseptal procedure). The main part of the procedure involves your doctor finding and ablating the multiple spots that cause Atrial fibrillation.
This procedure typically has a shorter length of hospital stay. One of the challenges to catheter ablation is that it is usually a longer procedure, and a return hospital visit may be required for additional interventions.


Question: What are the risks of catheter ablation?

Answer: As with any procedure, you are at risk for unplanned problems. These should be discussed with your doctor prior to intervention.


Question: I am currently taking medications for my Atrial fibrillation. Do I need surgery?

Answer: Medication therapy treats the symptoms associated with Atrial fibrillation, but have not been shown to be curative. Taking drug medication involves some risk. Surgical therapy has been shown to be a curative approach for Atrial fibrillation, but also incurs risk. You should discuss the risks of both approaches with your doctor to determine what approach would be best for you.


Question: How effective are these procedures to cure Atrial fibrillation?

Answer: Success rates can vary depending on the type of Atrial fibrillation you have, and how long you have had it. Procedures continue to evolve rapidly that align the procedure with the patient’s Atrial fibrillation history. Ask your doctor for the most recent clinical results available.


Question: Are these surgeries or procedures covered by private insurance?

Answer: Many insurance plans cover these surgeries and procedures. Please check with your Doctor or insurance provider to determine your individual coverage and eligibility.


Question: What should I expect during the recovery period of my procedure?

Answer: Your recovery will depend on the approach taken. Every patient responds differently to medical procedures. Ask your doctor about what you can expect for the approach you decide to take.

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