Maze Heart Surgery

Candidates for the Maze Procedure

Because the maze procedure requires open heart surgery, it is usually reserved for patients whose atrial fibrillation has not responded well to medication, whose symptoms interfere with their quality of life, and those at high risk for blood clots or stroke.

The maze procedure may be considered a treatment option for:

• Patients of many ages
• In conjunction with other open-heart procedures, such as coronary artery bypass and mitral valve repair and replacement
• Patients who previously had heart surgery

The maze procedure as a treatment option depends on a comprehensive diagnosis and how the patient responds to other treatments. The Mayo Clinic model of care lends itself well to this challenge by emphasizing an integrated, collaborative team approach individualized to each patient. This model means the patient's case is examined from the perspective of highly subspecialized medical experts, who collaborate to determine the most accurate diagnosis and the most effective treatment.

Age range of patients

Patients who undergo the maze procedure are from late adolescence to people in their 80s, with most in their 50s. Most patients have been suffering from atrial fibrillation for about eight years.

In conjunction with other open-heart procedures

Patients who have atrial fibrillation and are undergoing open-heart surgery for another condition may benefit from having the maze procedure at the same time. In 78 percent of patients who had the maze procedure at Mayo Clinic, it was performed in conjunction with another open-heart procedure, including:

• coronary artery bypass grafting (CABG)
• mitral valve repair or replacement
• atrial septal defect repair

The maze procedure typically adds 30 to 40 minutes to the mitral valve operation. For many patients who have mitral valve repair or replacement, the maze procedure may mean freedom from long-term use of blood-thinning drugs.

For patients who previously had heart surgery

It is possible for patients who previously had heart surgery to undergo the maze procedure. The same is true for people who have a pacemaker or have had a previous atrial-ventricular node ablation. The maze procedure is not always feasible after AF ablation. Patients who have had the maze procedure may also need a pacemaker.

Long-term follow-up of patients has shown no adverse or unexpected findings, with patients demonstrating a low risk of stroke (less than one-half percent) and the majority of patients no longer take blood-thinning medications.