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FAQ: Maze Surgeries

“When should A-Fib patients consider a full Cox Maze or a Mini-Maze surgery instead of a Catheter Ablation?” 

Surgical Maze pattern of series of lesions; used with permission Nature Publishing Group

Surgical Maze pattern of series of lesions

There are several specific circumstances in which you might consider a Maze surgery:

• You are having other heart-related surgery. If you have to undergo open heart surgery for another heart problem, such as a Mitral Valve replacement, the Cox Maze operation can be performed concurrently with your other heart surgery.

• You don’t qualify for a catheter ablation. If you can’t take blood thinners, for example, you can’t have an ablation.

• You’ve already had a stroke. Or you are in danger of having a stroke during a catheter ablation.

• You’re morbidly obese. It’s more difficult to see a clear image of the heart with current imaging systems during a catheter ablation if someone is significantly overweight.

A word of caution—the Maze/Mini-Maze are surgical operations with the potential risks and complications of surgery.
Maze incisions

Typical Mini-Maze incisions for surgical ablation of A-Fib

Current Guidelines for the Management of Patients with A-Fib

Surgery isn’t recommended as a first choice by current A-Fib treatment guidelines. The Maze surgeries are more invasive, traumatic, risky and with longer (in hospital) recovery times.

In general, candidates for Maze or Mini-Maze surgeries, are patients with significant, frequent A-Fib symptoms that do not respond to medication or catheter ablation. Patients who are unaware of their A-Fib symptoms are probably not candidates.

However, each case is unique, so it’s best to discuss your options with your cardiologist.

Find the Right Doctor

To find the right electrophysiologist (EP) for you, see Finding the Right Doctor for You and Your A-Fib.

Resource for this article
2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: Executive Summary. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. Journal of the American College of Cardiology, Volume 64, Issue 21, December 2014. DOI: 10.1016/j.jacc.2014.03.021.

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