Open Chest Maze Procedure

What you should know

Open chest maze procedure is heart surgery done to treat atrial fibrillation. Atrial fibrillation is an irregular and often rapid heartbeat. It is caused by fast random electrical messages to the heart muscle. The maze procedure makes a new heartbeat pathway that is shaped like a maze. The new pathway stops random messages and helps the heart to have a regular beat and normal rate. This procedure decreases your risk of stroke. The open chest maze procedure is usually done when other open heart surgery is needed.

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

• During or after the procedure 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 which can cause pain and swelling. Clots can stop blood from flowing where it needs to go in your body and can be life-threatening. The blood clot can go to your lungs. This can cause chest pain and trouble breathing. A blood clot may go to your brain and cause a stroke.
  
  
• Your symptoms may get worse if you do not have this procedure. You may have a heart attack or stroke which can be life-threatening. Ask your caregiver if you have questions about your condition, your procedure, or these risks.

Getting Ready

The week before your procedure:

• Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.
  
  
• Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.
  
  
• Write down the correct date, time, and location of your procedure.
  
  
• You may need to have an electrocardiogram (ECG), electrophysiologic studies (EPS), and blood tests. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.
  
  
• Arrange a ride home. Ask a family member or friend to drive you home after your surgery or procedure. Do not drive yourself home.

The night before your procedure:

• You will need to stop eating and drinking for several hours before your procedure. Ask your caregiver for more information on when you should do this.
  
  

The day of your procedure:

• Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  
  
• An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine to make you sleepy before your procedure or surgery. Tell your caregiver if you or anyone in your family has had a problem using anesthesia in the past.
  
  
• You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

Treatment

What will happen:

• You will be given general anesthesia to keep you asleep. A tube will be used to keep your airway open and help you breathe. An incision (cut) 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 the procedure. Caregivers will work on your heart to make a new pathway for electrical messages.
  
  
• 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 surgery:

You are taken to the recovery room or an intensive care unit (ICU). Caregivers will watch you very closely. A bandage is used to cover your stitches or staples. This bandage keeps the area clean and dry to help prevent infection. A caregiver may remove the bandage shortly after surgery to check the incision. Do not get out of bed until your caregiver says it is OK. Your family may be allowed to visit you in the ICU for a short visit several times a day.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

• You cannot make it to your procedure on time.
  
  
• You have a fever.
  
  
• You have questions or concerns about your procedure.

Seek Care Immediately if

• Call 911 or an ambulance if you have any signs of a heart attack:
  
  
  • Discomfort in the center of your chest that feels like squeezing, pressure, fullness, or pain, that lasts for more than a few minutes or keeps returning
    
    
  • Discomfort or pain in your back, neck, jaw, stomach, or one or both of your arms
    
    
  • Feeling sick to your stomach
    
    
  • Having trouble breathing
    
    
  • A sudden cold sweat, particularly in combination with chest discomfort or trouble breathing
    
    
  • Feeling very lightheaded or dizzy, particularly in combination with chest discomfort or trouble breathing
  
  
• You have signs of a stroke: The following signs are an emergency. Call 911 immediately if you have any of the following:
  
  
  • Weakness or numbness in your arm, leg, or face (may be on only one side of your body)
    
    
  • Confusion and problems speaking or understanding speech
    
    
  • A very bad headache that may feel like the worst headache of your life
    
    
  • Not being able to see out of one or both of your eyes
    
    
  • Feeling too dizzy to stand