The “classic” or “cut and sew” Maze procedure is a traditional surgical approach to treating atrial fibrillation. During the classic Maze procedure, multiple incisions are made in the right and left atria (the upper chambers of the heart) to isolate abnormal electrical signals or impulses that cause atrial fibrillation. The left atrial appendage (a pocket-like section in the left atrium), often a source of blood clot formation and stroke, is completely removed. The incisions are then sewn closed.
As the incisions heal, they form a pattern of scars. These scars redirect the abnormal electrical signals that cause atrial fibrillation. Because the incisions are made from the inside of the heart, patients undergo “open heart surgery” and during surgery are placed on a heart-lung or “bypass” machine. The heart-lung machine temporarily takes over the function of the heart and lungs during surgery.
The classic Maze procedure may be performed on those patients whose only cardiac condition is atrial fibrillation, or in conjunction with surgery for other heart conditions. Frequently patients that undergo the classic Maze procedure have tried multiple treatments for atrial fibrillation including medications, cardioversion and catheter ablation without success.
TT Maze Procedure
A total thoracoscopic Maze (TT Maze) procedure is a minimally invasive procedure in which a cardiac surgeon uses special instruments to make small incisions on the sides of the chest to access the heart. The cardiac surgeon then creates scar patterns on the outside of the heart to disrupt (or focus) the irregular flow of electricity causing the atrial fibrillation. If atrial fibrillation persists, a cardiac electrophysiologist will then perform a catheter ablation. The TT Maze procedure is a “one-two punch” combination procedure to eliminate atrial fibrillation.
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