What is a maze procedure?

A maze procedure is surgery to treat atrial fibrillation. Atrial fibrillation is a type of heart arrhythmia or abnormal heart rhythm. Atrial fibrillation occurs when the electrical signal that causes your heart to beat travels through the heart muscle in a disorganized manner. This results in a heartbeat that is too fast and irregular. Having atrial fibrillation puts you at risk of stroke and heart failure.

A maze procedure involves making a series of cuts in the heart muscle and sewing them back together. As the cuts heal, your body makes scar tissue that blocks the disorganized electrical signal and irregular heart rhythm. This allows your heart to beat normally.

A maze procedure is major surgery that has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having a maze procedure. 

Why is a maze procedure performed? 

Your doctor may recommend a maze procedure to treat symptomatic atrial fibrillation. Your doctor may only consider a maze procedure for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your treatment options and consider getting a second opinion.

Your doctor may recommend a maze procedure in the following situations: 

  • You are not able to tolerate medication therapy or medication therapy has not helped your atrial fibrillation.
  • You are not able to take anticoagulant or blood thinners, such as warfarin (Coumadin).
  • You have had a stroke or you are at high risk of having a stroke.

Who performs a maze procedure?

Cardiac surgeons and thoracic surgeons perform maze procedures. Cardiac surgeons specialize in the surgical treatment of conditions of the heart and its blood vessels. Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs and esophagus. Cardiac surgeons and thoracic surgeons may also be known as cardiothoracic surgeons. 

How is a maze procedure performed?

Your maze procedure will be performed in a hospital. Your surgeon can use either a traditional open-heart surgery method or a minimally invasive method. A heart-lung machine is necessary for the open-heart method. Your surgical team will stop your heart with medicine and the heart-lung machine will pump blood to the body. When the surgery is complete, your surgeon will take your heart off the machine.

Surgical approaches to a maze procedure

Your surgeon will perform your maze procedure using one of the following approaches:

  • Minimally invasive surgery involves inserting special instruments and an endoscope through at least two small incisions in the side of your chest. The endoscope is a thin, lighted instrument with a small camera. The camera transmits pictures of the inside of your chest to a video screen. Your surgeon sees the inside of your chest on the screen while performing surgery. Minimally invasive surgery generally involves a faster recovery and less pain than open surgery. This is because it causes less trauma to tissues and organs. Your doctor will make a small incision instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery. Your minimally invasive surgery may also include the use of a surgical robot and special imaging technologies (computer-assisted surgery) to assist your doctor in viewing and performing the surgery.
  • Open surgery involves making a large incision in the front of your chest and breastbone. Open surgery allows your doctor to directly see and access the surgical area. Open surgery generally involves a longer recovery and more pain than minimally invasive surgery. Open surgery requires a larger incision and more cutting and displacement of muscle and other tissues than minimally invasive surgery. Despite this, open surgery may be a safer or more effective method for certain patients.