Open Chest Maze Procedure

WHAT YOU SHOULD KNOW:

• Open chest maze procedure is an open heart surgery done to treat atrial fibrillation. Atrial fibrillation, also called AF or A-fib, is the most common irregular heart rhythm (beat) problem. Normally, an electrical impulse (stimulus) is triggered by the sino-atrial node in the atria (top chambers of the heart). This impulse travels to the atrium and down the ventricles (lower chambers) in an orderly way. With AF, there are abnormally fast and disorganized impulses stimulating the atria. These impulses begin all together and go in different directions causing irregular, rapid, disordered, and ineffective heartbeats. When your heart beats too fast, you may have problems with the flow of blood in your body. Blood clots may form and cause angina (chest pain), heart attack, or a stroke.
  
  
• During an open chest maze procedure, a maze is created where the electrical impulse will take only one path. This maze is done by making and sewing incisions (cuts) on the left and right atrium to form scar tissue. This scar tissue will stop abnormal electrical signals from stimulating the atrium. Your caregiver may also use freezing substances, or radiowave, microwave, or ultrasound energy to make this scar tissue. Once the abnormal impulses are blocked or redirected, a normal heart rhythm may be restored. With an open chest maze procedure, atrial fibrillation may be treated and quality of life improved.

AFTER YOU LEAVE:

Medicines:

• Keep a written list of the medicines you take, the amounts, and when and why you take them. Bring the list of your medicines or the pill bottles when you see your caregivers. Learn why you take each medicine. Ask your caregiver for information about your medicine. Do not use any medicines, over-the-counter drugs, vitamins, herbs, or food supplements without first talking to caregivers.
  
  
• Always take your medicine as directed by caregivers. Call your caregiver if you think your medicines are not helping or if you feel you are having side effects. Do not quit taking your medicines until you discuss it with your caregiver. If you are taking medicine that makes you drowsy, do not drive or use heavy equipment.

• Diuretics: This medicine is often called "water pills". Diuretics help your body get rid of extra fluid (edema) in your legs and ankles. This medicine may also help get rid of extra fluid in your lungs or around your heart. It may also decrease your blood pressure. You may urinate more often when taking diuretics.
  
  
• Clot busters: This medicine helps break apart blood clots, which may increase blood flow to your heart muscle. It is given in your IV and may be given at the same time as other blood thinners. This medicine may decrease the amount of damage to your heart muscle, and may even save your life. You will bleed and bruise more easily after getting clot busters.
  
  
• Heart medicine: This medicine may be given to make your heart beat stronger or more regularly. There are many different kinds of heart medicines. Talk with your caregiver to find out what your medicine is and why you are taking it.
  
  
• Pain medicine: You may be given medicine to take at home to take away or decrease pain. Your caregiver will tell you how much to take and how often to take it. Take the medicine exactly as directed by your caregiver. Do not wait until the pain is too bad before taking your medicine. The medicine may not work as well at controlling your pain if you wait too long to take it. Tell caregivers if the pain medicine does not help, or if your pain comes back too soon.

Ask your caregiver when to return for a follow-up visit. Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.

Wellness hints:

• Eating and drinking:
  
  
  • Eat a variety of healthy foods such as fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meat and fish. Eating healthy foods may help you have more energy and heal faster. Ask your caregiver if you need to be on a special diet.
    
    
  • Men 19 years old and older should drink about 3.0 Liters of liquid each day (close to 13 eight-ounce cups). Women 19 years old and older should drink about 2.2 Liters of liquid each day (close to 9 eight-ounce cups). Follow your caregiver's advice if you must change the amount of liquid you drink. For most people, good liquids to drink are water, juices, and milk. If you are used to drinking liquids that contain caffeine, such as coffee, these can also be counted in your daily liquid amount. Try to drink enough liquid each day, and not just when you feel thirsty.
  
  
• Start exercising: Talk to your caregiver before you start exercising. Together you can plan the best exercise program for you. It is best to start slowly and do more as you get stronger. Exercising can help make your heart stronger, lower your blood pressure, and keep you healthy.
  
  
• Quit smoking: It is never too late to quit smoking. Smoking harms the heart, lungs, and the blood. You are more likely to have a heart attack, lung disease, and cancer if you smoke. You will help yourself and those around you by not smoking. Ask your caregiver for more information about how to stop smoking if you are having trouble quitting.
  
  
• Avoid stress: Stress may slow healing and cause illness. Since it is hard to avoid stress, learn to control it. Learn new ways to relax, such as deep breathing. Talk to your caregiver about things that upset you.

Lifestyle changes:

• Alcohol: Do not drink alcohol. Alcohol can damage your brain, heart, and liver. Almost every part of your body can be harmed by alcohol. Drinking alcohol can also make your illness worse. Talk to your caregiver if you drink alcohol, and ask for information about how to stop.
  
  
• Rest: You may feel like resting more. Slowly start to do more each day. Rest when you feel it is needed.

Wound care: When you are allowed to bathe or shower, carefully wash the incisions with soap and water. Afterwards, put on clean, new bandages. Change your bandages any time they get wet or dirty. Ask your caregivers for more information about wound care.

CONTACT A CAREGIVER IF:

• You have a fever (increased body temperature).
  
  
• You have nausea (upset stomach) or vomiting (throwing up).
  
  
• You have redness, discharge, or pain in the incision area or where the catheter was inserted.
  
  
• You have questions or concerns about your open chest maze procedure, illness, or medicine.

SEEK CARE IMMEDIATELY IF:

• You have signs of a heart attack:
  
  
  • Chest pain or discomfort that spreads to your arms, jaw, or back.
    
    
  • Unusual, sudden back pain.
    
    
  • Nausea (sick to your stomach).
    
    
  • Trouble breathing.
    
    
  • Sweating.
    
    
  • Lips or nailbeds that turn blue or white in color.
    
    
  • This is an emergency. Call 911 or 0 (operator) for an ambulance to get to the nearest hospital or clinic. Do not drive yourself!
  
  
• You have signs and symptoms of a stroke: You have one or more of these signs and symptoms of a stroke. These signs and symptoms may happen suddenly:
  
  
  • A very bad headache. This may feel like the worst headache of your life.
    
    
  • Too dizzy to stand.
    
    
  • Weakness or numbness in your arm, leg, or face. This may happen on only one side of your body.
    
    
  • Confusion and problems speaking or understanding things.
    
    
  • Not able to see out of one or both of your eyes.
    
    
  • This is an emergency. Call 911 or 0 (operator) for an ambulance to get to the nearest hospital. Do not drive yourself!
  
  
• There is bleeding, increased bruising, and swelling in the incision area or where the catheter was inserted.
  
  
• Your leg used for the catheterization becomes cold, numb, pale, or is very painful.
  
  
• Your signs and symptoms come back or get worse.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

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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