Minimally Invasive Maze Procedure

WHAT YOU SHOULD KNOW:

Minimally Invasive Maze Procedure (Inpatient Care) Care Guide

A minimally invasive maze procedure is an endoscopic surgery done to treat atrial fibrillation.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • Problems may happen during this surgery that may lead to an open chest surgery. During this surgery, your heartbeat may stop. This may decrease blood flow further and lead to a heart attack. A blood vessel or your atria may get injured, causing a large amount of blood loss. You could also have trouble breathing, an infection, or bleed more than expected after this surgery.

  • Without treatment, your symptoms such as a fast heartbeat, trouble breathing, getting tired easily, and other heart problems may worsen. Reduced blood flow or a blood clot may lead to serious and life-threatening conditions. These conditions may include angina (chest pain), heart attack, or a stroke.

WHILE YOU ARE HERE:

Before your surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.

  • A Foley catheter is a tube caregivers put into your bladder to drain your urine into a bag. Keep the bag below your waist. This will help prevent infection and other problems caused by urine flowing back into your bladder. Do not pull on the catheter, because this may cause pain and bleeding, and the catheter could come out. Keep the catheter tubing free of kinks so your urine will flow into the bag. Caregivers will remove the catheter as soon as possible, to help prevent infection.

  • Tests:

    • Blood tests may be done to get information about your overall health.

    • Cardiac catheterization is a procedure done to find the cause of and treat a heart condition. A thin, bendable tube inserted into an arm, neck, or groin vein is moved into your heart. Your caregiver may use an x-ray to guide the tube to the right place. Contrast dye may be put into your vein so the pictures show up better on a monitor.

    • An EKG test records your heart rhythm and how fast your heart beats.

  • General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

During your surgery:

  • An endotracheal tube (ET) connected to a breathing machine may be put into your mouth or nose. The tube is used to keep your airway open and help you breathe during surgery. Your surgeon may need to insert a pulmonary artery catheter to see how well your heart is working. A catheter is a tube that is threaded into your heart through a blood vessel in your chest, neck, arm, or leg. Another tube with a small ultrasound sensor on the end may also be moved down into your esophagus. This will allow your caregiver to see your heart clearly.

  • Your caregiver will make a small incision in your chest to insert the endoscope through. Two smaller incisions are also made between the ribs to insert the other instruments. Small incisions will be made in the right and left atria (upper chambers) of your heart and then sewn closed. This will form scar tissue and a maze where the impulses can travel in only one direction. Your surgeon may also use freezing substances, or radiowave, microwave, or ultrasound energy to create these scar tissues. The openings and incisions in your chest are then closed with stitches and staples. A bandage is placed over your incision to control bleeding.

After your surgery:

You will be taken to a room to rest until you are fully awake. Caregivers will monitor you closely for any problems. Do not get out of bed until your caregiver says it is okay. When your caregiver sees that you are okay, you will be able to go home or be taken to your hospital room. Caregivers may leave you connected to a ventilator (breathing machine) after surgery to give you oxygen. You may have the ET tube removed after you are awake and can breathe well on your own. The catheter inserted for surgery may be removed and a tight pressure bandage will cover the incision. A caregiver may remove the bandages soon after surgery to check your wound.

  • You will need to lie flat and still in bed for a few hours. Caregivers will help you roll from side to side. If an artery in your groin was used for the surgery, you must keep your leg straight. Do not bend it until your caregiver tells you it is okay. Your caregiver will also tell you when it is okay to get out of bed. Call your caregiver before you get up for the first time. If you feel weak or dizzy after you get up, sit or lie down right away and call your caregiver.

  • You may need to wear pressure stockings or inflatable boots after surgery. The stockings are tight and put pressure on your legs. The boots have an air pump that tightens and loosens different areas of the boots. Both of these improve blood flow and help prevent clots.

  • A temporary pacemaker is a device that helps your heart beat at a normal speed and in a regular rhythm. It is connected to the wires that were put into your heart muscle during your surgery. The wires may then be connected to a small pacemaker outside of your body. You may need this pacemaker treatment just for a short time.

  • Medicines:

    • Antibiotics help treat or prevent an infection caused by bacteria.

    • Antinausea medicine helps calm your stomach and prevents vomiting.

    • Anticoagulants are a type of blood thinner medicine that helps prevent clots. Clots can cause strokes, heart attacks, and death. These medicines may cause you to bleed or bruise more easily.

      • Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth and a soft toothbrush. If you shave, use an electric razor. Avoid activities that can cause bruising or bleeding.

      • Tell your primary healthcare provider (PHP) about all medicines you take because many medicines cannot be used with anticoagulants. Do not start or stop any medicines unless your PHP tells you to. Tell your dentist and other caregivers that you take anticoagulants. Wear a bracelet or necklace that says you take this medicine.

      • You will need regular blood tests so your PHP can decide how much medicine you need. Take anticoagulants exactly as directed. Tell your PHP right away if you forget to take the medicine, or if you take too much.

      • If you take warfarin, some foods can change how your blood clots. Do not make major changes to your diet while you take warfarin. Warfarin works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables, broccoli, grapes, and other foods. Ask for more information about what to eat when you take warfarin.

    • Diuretics decrease edema (excess fluid) that collects in a part of your body, such as your legs. Diuretics can also remove excess fluid from around your heart or lungs and decrease your blood pressure. You may urinate more often when you take this medicine.

    • Heart medicine is given to strengthen or regulate your heartbeat.

    • Pain medicine may be given. Tell caregivers right away if you start feeling discomfort, pressure, burning, or tightness in your chest. Tell caregivers right away if you start sweating, have trouble breathing, or feel discomfort in your arm, back, neck, or jaw. Any of these may be a sign that your heart is not getting enough oxygen, and may need medicine to help.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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