Maze is a surgical procedure for the heart. A maze-like pattern of incisions is made in the upper chambers of the heart. The chambers are called the atria.
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Maze is done to treat
. Fibrillation is abnormal beating of the heart muscle. It is caused by erratic electrical impulses that travel through the heart muscle. These impulses can cause the chambers to beat too fast. This can decrease blood flow through the heart. Atrial fibrillation can also cause blood clots to form in the heart that can travel to the brain and cause a
Maze is used to treat severe cases that did not respond to medicine or other procedures. Electrical impulses cannot flow through scar tissue. By creating specific patterns of scar tissue, maze surgery creates a pathway for healthy impulses and blocks erratic impulses.
Complications are rare, but no procedure is completely free of risk. If you are planning to have this procedure, your doctor will review a list of possible complications, which may include: InfectionBleedingAnesthesia-related problems
The need for a permanent
pacemakerKidney or other organ failureStrokeDeath
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as: SmokingDrinkingChronic disease such as diabetes or obesityThe use of certain medications
Your doctor may do the following: Physical exam, including blood and urine testsChest x-ray
—makes pictures of structures inside the chest using a small amount of radiation
(ECG, EKG)—a test that records the heart’s activity by measuring electrical currents through the heart muscle
In the days leading up to the procedure:
Talk to your doctor about your medicines, including over-the-counter medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
Anti-inflammatory drugs (eg, aspirin )Blood thinners, such as clopidogrel (Plavix), warfarin (Coumadin), or ticlopidine (Ticlid)Arrange for someone to drive you home from the hospital. Also, have someone help you at home.Eat a light meal the night before. Do not eat or drink anything after midnight.If you smoke, it is best to stop.
will be used. You will be asleep during the surgery. You may also be given a sedative before surgery to help you relax.
After you are asleep, the doctor will cut through the skin and breastbone. The chest cavity will be opened. Next, the heart will be connected to the heart-lung machine. This machine will take over the functions of the heart and lungs during surgery. Once the machine is active, the heart will be stopped.
A series of small cuts will be made in the atria. The cuts will be made in a maze-like pattern to direct the electrical impulses. The incisions will then be closed with sutures. In some cases, a pacemaker may need to be placed.
Once the maze-like pattern has been completed, the heart will be restarted. When the heart is working well, you will be removed from the heart-lung machine. The chest will be closed with wires. Finally, the skin will be closed with sutures.
Your recovery will be monitored in the intensive care unit. Your heart’s activity will be recorded by EKG. Pain medicine will be given to help you rest comfortably.
Anesthesia prevents pain during surgery and early recovery. Your chest will be very sore. You may have a pain pump with IV medicine for the first few days. Your doctor will recommend other medicine to help manage soreness later in recovery.
While you are recovering at the hospital, you may receive the following care: Fluids and pain medicine will be given through an IV line. You may be given medicine to help control build up of fluids.Efforts will be made to get you out of bed and walking as soon as possible.You will be asked to do deep breathing and coughing exercises. This will help reduce the risk of fluid build up in your lungs.If a pacemaker was placed, you will be given instruction on its care.
During your stay, the hospital staff will take steps to reduce your chance of infection such as: Washing their handsWearing gloves or masksKeeping your incisions covered
There are also steps you can take to reduce your chances of infection such as: Washing your hands often and reminding visitors and healthcare providers to do the sameReminding your healthcare providers to wear gloves or masksNot allowing others to touch your incisions
It can take up to six months to fully recover. Be sure to follow your doctor’s instructions, which may include: Rest when needed. At first, it is normal to feel more tired than usual.Walk daily. Activity will help with the healing process.Take the pain medicine as directed. Some pain medicine causes constipation. To prevent this, drink plenty of fluids and eat high-fiber foods.Keep the incision area clean and dry.Limit certain activities (eg, driving, working, doing strenuous exercise) until you have recovered.
Ask your doctor about when it is safe to shower, bathe, or soak in water.
After you leave the hospital, call your doctor if any of the following occurs: Cough or shortness of breathNew chest painSigns of infection, including fever and chillsPalpitations or rapid heart rateRedness, swelling, increasing pain, excessive bleeding, or discharge from the incision siteNausea and/or vomiting that you cannot control with the medicines you were given after surgery, or which persist for more than two days after discharge from the hospitalPain that you cannot control with the medicines you have been givenCoughing up bloodHeadache or feeling faintInability to urinatePain, burning, urgency, frequency of urination, or persistent bleeding in the urinePain and/or swelling in your feet, calves, or legsOther worrisome symptoms
Call for medical help or go to the emergency room right away if any of the following occurs: Sudden chest painSudden shortness of breathProblems with vision or speakingNumbness or weakness on one side of your body
If you think you have an emergency, call for medical help right away.
Maze procedure for treatment of atrial fibrillation. University of Southern California, Cardiothoracic Surgery website. Available at:
http://www.cts.usc.edu/mazeprocedure.html. Accessed March 12
Maze surgery. Texas Heart institute website. Available at:
http://www.texasheartinstitute.org/HIC/Topics/Proced/mazes.cfm. Updated August 2009. Accessed March 12, 2010
Patient information: the maze procedure. Society of Thoracic Surgeons website. Available at:
http://www.sts.org/doc/4511. Updated June 2000. Accessed March 3
A patient’s guide to heart surgery. University of Southern California, Cardiothoracic Surgery website. Available at:
http://www.cts.usc.edu/hpg-index.html. March 12, 2010.
Last reviewed December 2013 by Michael J. Fucci, DO
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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