Mini-Maze Procedure—Minimally Invasive Surgery
The Mini-Maze procedure is a surgical procedure of the heart. A pattern of scars are made in the upper chambers of the heart which may look like a maze. The chambers are called the atria.
A traditional maze surgery requires the chest to be opened and the heart to be stopped. A mini-maze is done with small incisions and special surgical tools. This often leads to shorter recovery time and lower risk of infection.
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Reasons for Procedure
The Maze procedure is done to cure atrial fibrillation. Fibrillation is abnormal beating of 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 stroke.
The Maze procedure is used to treat severe cases that did not respond to medication 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.
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Anesthesia-related problems
- The need to switch to an open procedure
- Damage to other organs
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
What to Expect
Prior to Procedure
Depending on the reason for your surgery, your doctor may do the following:
- Physical exam, including blood and urine tests
- Chest x-ray
- ECG —to test the electrial activity of the heart
In the days leading up to the procedure:
- Talk to your doctor about your medications, including over-the-counter medications. You may be asked to stop taking some medications up to one week before the procedure.
- Arrange for someone to drive you home from the hospital and 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.
General anesthesia will be used. You will be asleep during the surgery. You may also be given a sedative before surgery to help you relax.
Description of the Procedure
Minimally invasive procedure only requires small cuts to be made in the chest wall. Two small incisions will be made along your side. A small camera will be inserted through one of the incisions. The doctor will be able to look at the heart with this camera. A second tool will be used to create small areas of scar tissue. The tip of the tool uses extreme cold or radiowaves to destroy small areas of tissue. This process is called ablation.
Once the chosen areas have been treated, the instruments will be removed. The skin will be closed with stitches or staples.
Immediately After Procedure
Your recovery will be monitored in the intensive care unit. Your heart’s activity will be recorded by ECG. Pain medication will be given to help you rest comfortably.
How Long Will It Take?
About 3-4 hours
How Much Will It Hurt?
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
Average Hospital Stay
About 3 days
At the Hospital
While you are recovering at the hospital, you may receive the following care:
- Fluids and pain medication will be given through an IV line. You may be given medication to help control the 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.
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
- Washing their hands
- Wearing gloves or masks
- Keeping 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 same
- Reminding your healthcare providers to wear gloves or masks
- Not allowing others to touch your incisions
It can take up to 3-4 weeks 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.
- Keep the incision area clean and dry.
- Limit certain activities until you have recovered.
Call Your Doctor
It is important to monitor your recovery. Alert your doctor to any problems. If any of the following occur, call your doctor:
- Cough or shortness of breath
- New chest pain
- Signs of infection, including fever and chills
- Palpitations or rapid heart rate
- Redness, swelling, increasing pain, excessive bleeding, or discharge from an incision site
- Persistent nausea or vomiting
- Pain that you cannot control with the medications you were given
- Coughing up blood
- Headache or feeling faint
- Inability to urinate
- Pain, burning, urgency, frequency of urination, or persistent bleeding in the urine
- Pain or swelling in your feet, calves, or legs
- New or unexpected symptoms
Call for emergency medical services or go to the emergency room right away if any of the following occurs:
- Sudden chest pain
- Sudden shortness of breath
- Problems with vision or speaking
- Numbness or weakness on one side of your body
If you think you have an emergency, call for emergency medical services right away.
American Heart Association
Heart Rhythm Society
Canadian Heart Rhythm Society
Heart and Stroke Foundation of Canada
Cardiac rhythm disturbances. Society of Thoracic Surgeons website. Available at: https://ctsurgerypatients.org/adult-heart-disease/cardiac-rhythm-disturbances. Updated July 2016. Accessed November 28, 2017.
Maze procedure for treatment of atrial fibrillation. University of Southern California Cardiothoracic Surgery website. Available at: http://www.surgery.usc.edu/cvti/mazeprocedure.html. Accessed November 28, 2017.
Maze surgery. Texas Heart institute website. Available at: http://www.texasheart.org/HIC/Topics/Proced/mazes.cfm. Updated August 2016. Accessed November 28, 2017.
Last reviewed November 2018 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC Last Updated: 12/20/2014