Procedure options and details
With the traditional Maze procedure your surgeon works closely with a cardiac anesthesiologist to ensure you’re asleep and comfortable. Next, they:
- Create an incision through the breastbone (sternotomy) to access the heart.
- Use cardiopulmonary bypass with a heart-lung machine to take over the work of your heart, so your heart is still while the surgeon works.
- Create scars. These methods can be used to generate scar tissue:
- Scalpel: This approach creates scar tissue by cutting into the heart tissue.
- Radiofrequency: This approach uses heat energy to create scar tissue.
- Cryoablation: This approach uses extreme cold to generate scar tissue.
- Perform other procedures like valve repair or pacemaker placement while you remain under general anesthesia.
- Remove you from the heart-lung machine and close the incision. You will recover in a room just outside the operating suite before being transferred to a room in the intensive care unit (ICU).
Today, Penn cardiac surgeons can routinely access the heart through much smaller incisions. The use of cardiopulmonary bypass isn’t necessary. To perform a minimally invasive Maze (mini-Maze) procedure, your surgeon and anesthesiologist use general anesthesia. Then, your surgeon:
- Creates one 3-to-4-inch incision or several half-inch incisions through the chest wall between the ribs (thoracotomy).
- Inserts tiny surgical tools like high-definition cameras and surgical instruments through the chest incisions to access the heart.
- Creates scar tissue with the same scar-generating methods as with the traditional Maze procedure.
- Closes the incision(s) to begin the recovery process.
Because surgery is generally a last resort for A-Fib, your care team may recommend catheter ablation. This type of procedure uses only a tiny incision in the groin. Penn electrophysiologists have an extensive track record of successfully using catheter ablation for A-Fib with excellent outcomes.
Your doctor can also use a minimally invasive approach to insert an LAA device that prevents blood clots from forming. Learn more about the WATCHMAN™ device.