[CVICURN2003]

Originally Posted by zambezi

Our cardiac surgeons occassionally do maze procedures while they are doing a cabg or valve...with the maze procedure, tiny cuts are made on the myocardium (i believe with a laser) to ablate alternate pathways...as others have mentioned, it is ususally used for those that have chronic afib...in my experience, these patients often have some bouts of junctional rhythm after surgery, occassionally requiring pacing...

That sounds like a TMR to me, not a MAZE.

[CVICURN2003]

Originally Posted by mrsituation

MAZE aka MAZE/COX procedure....
http://www.clevelandclinic.org/heart...ation/maze.htm

In theory; surgical slits are made in atrial wall and create scar tissue. it is the scar tissue that inhibit the abnormal electrical conduction from SA --> AV node. Since that is interrupted then the heart's own inherent conduction system then originates from the AV node. For a more detailed explanation, check out the hotlink, hope it helps.

We are going to be one of the hospitals doing the COX Maze IV. It is for persistant or long lasting (Class II or III) afib. It isolates all places between the RPV and the LPV and "draws a line" from between the two upper PV and down to the mitral valve. We will do this though a small thoracotomy incision. Just like we do the Cox Maze III now. We do do these in conjuction with CABG. Our MD's, a cv surgeon and our EP MD that will be doing it are in training this week and we will have our first case (out of the 11 on the waiting list, next week). It has a longer success rate.

[metallicalady]

Originally Posted by TopherSRN

Your getting Transmyocardial Revascularization (TMR) and a MAZE confused. TMR is where a laser is used to 'drill' holes through the myocardium in order to promote collateral capillary beds as a method of perfusion.

A MAZE is a procedure where the atria and the pulmonary veins are surgically manipulated in order to reorganize the internodal pathways.


And YES you will see asystole, junctional, a flutter and EVEN afib in someone s/p MAZE. A fib will persist for up to 6 months. Its akin to seeing the wierd conductions in valves.


She told you to look it up because you will remember it better than if she had just told you. How hard is it to look things up these days with google?

It has been interesting reading re the MAZE proceedures, our Hospital does the largest amount of Cardiac Surgery in our state and the MAZE is only ever done in conjunction with valve or CABG. Our Cardiologists/Electrophysiologists do Alcohol Abalation via a femoral approach for those patients that have AF. And as previously stated the arrythmias post proceedure are variant and if the full affect of either the MAZE or the Alcohol Ablation take between 3 and 6 months and even then there is no guarantee that they are successful. The proceedure is as you say on here - related to the pulmonary veins and internodal pathways. Thanks for taking my 2 cents worth.

[Dinith88]

Originally Posted by mrsituation

it is the scar tissue that inhibit the abnormal electrical conduction from SA --> AV node. Since that is interrupted then the heart's own inherent conduction system then originates from the AV node. , hope it helps.

Just to clarify...because this statement is in error...and may confuse people...

The scar tissue created in MAZE procedures blocks 'bad' conduction/impulses that origionate in the left atrium (at the junction of the 4 pulmonary veins and the atrium)...NOT "abnormal SA node conduction". (impulses origionating from SA node are called 'sinus'). And, if the heart's "...own inherent conduction system then origionates from the AV node..." the rhythm would be 'junctional' not 'sinus'...(goal of MAZE is to restore sinus rhythm, not induce junctional)

Didnt get a chance to read your link but if it is where your information came from it's a bad link...