Open Chest Maze Procedure

WHAT YOU SHOULD KNOW:

Open Chest Maze Procedure (Inpatient Care) Care Guide

An open chest maze procedure is heart 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:

You may bleed more than expected and need additional surgery. Your body may hold onto too much fluid, or your kidneys may fail. You may have swelling of the heart or other tissues. Your heart may not work as it should after surgery. You may need a permanent pacemaker. You may continue to have atrial fibrillation for several months after your surgery. You may get a blood clot in your leg or arm. This may become life-threatening. Without this surgery, your symptoms may get worse. You may have a heart attack or stroke, which can be life-threatening.

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.

  • 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:

A tube will be used to keep your airway open and help you breathe. An incision is made in the center of your breastbone or in your chest wall. You will be connected to a heart-lung bypass machine that does the work of your heart and lungs during surgery. The surgeon will work on your heart to make a new heartbeat pathway that is shaped like a maze. You will be taken off of the heart-lung bypass machine, allowing your heart and lungs to work on their own. Caregivers may put wires into your chest that stay there for a short time after surgery to improve your heartbeat. The incision in your chest is closed with wire and stitches.

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.

  • You may need to walk around the same day of surgery , or the day after. Movement will help prevent blood clots. You may also be given exercises to do in bed. Do not get out of bed on your own until your caregiver says you can. Talk to caregivers before you get up the first time. They may need to help you stand up safely. When you are able to get up on your own, sit or lie down right away if you feel weak or dizzy. Then press the call light button to let caregivers know you need help.

  • You will be able to drink liquids and eat certain foods once your stomach function returns. You may be given ice chips at first. Then you will get liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft foods easily, you may slowly begin to eat solid foods.

  • An oxygen and a ventilator may be needed for a day or two after surgery. Caregivers may leave an endotracheal tube (ET tube) in your throat. Oxygen can be given through the ET tube by a breathing machine called a ventilator. After the ET tube is taken out, you may still need oxygen. The oxygen may be given through a plastic mask over your mouth and nose. Oxygen may also be given through nasal prongs (short, thin tubes in your nose).

  • A chest tube is used to remove air, blood, or fluid from around your lungs or heart. This will let your lungs fill up with air when you breathe, and will help your heart beat normally. The chest tube is attached to a container to collect the blood or fluid. Call a caregiver right away if the tube comes apart from the container. Let the caregiver know if the tubing gets bent, twisted, or the tape comes loose. You may need more than one chest tube.

  • An arterial line is a tube that is placed into an artery (blood vessel), usually in the wrist or groin. An arterial line may be used for measuring your blood pressure or for taking blood.

  • 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.

  • Deep breathing and coughing will decrease your risk for a lung infection. Take a deep breath and hold it for as long as you can. Let the air out and then cough strongly. Deep breaths help open your airway. You may be given an incentive spirometer to help you take deep breaths. Put the plastic piece in your mouth and take a slow, deep breath. Then let the air out and cough. Repeat these steps 10 times every hour.

  • 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.

  • Medicines:

    • Antiarrhythmics are given to make your heart beat at a regular rate and rhythm.

    • 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.

    • 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.

    • Blood thinners help prevent blood clots. Blood thinners may be given before, during, and after a surgery or procedure. Blood thinners make it more likely for you to bleed or bruise.

© 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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