Surgical ablation

Hi, I’m 18 and just wondering if anyone had experience with a open heart MAZE operation, if so I would be so great full for any advice on recovery or anything about the operation that I might need to know more about ! Thankyou for any help

[Mike11]

They performed a MAZE on me whilst they were inside me doing a quad heart bypass. Unfortunately the MAZE didn't work so I had to have an ablation a few years later.

Sorry to worry you but my recovery was horrific as the ribs just didn't seem to heal properly. I was in pain for four years until I found a consultant who specialised in chest rather than cardiac issues and he fixed me with a simple injection. I also lost some memory due to the heart bypass machine.

I assume you are not just being opened up for a MAZE procedure but are having something else done as well. If it's for a valve replacement, I really would suggest you look at some of the keyhole techniques now appearing.

Sorry to not be positive, and I know the bypass did save my life, but it really wasn't a good experience.

[Hidden in reply to Mike11]

Thank you for your input, it’s a lot easier for a doctor to tell you what should happen without letting you know about other techniques for the same thing ! Sorry you had a hard time recovering, my consultant I see is at The Royal Brompton in London and seems to think that I will recover well from it as I’m young and healthy, still a long journey but quicker than someone who was 50/60 according to him, and yes it is just for MAZE operation and so I shall definitely ask about a potential less invasive approach

Thanks again

Jasmin

[Mike11 in reply to Hidden]

Oh definitely !! You do realise they saw through the sternum, don't you ? You can only do that two or three times max before it falls apart so you need to be thinking about possible more serious heart surgery later - valve replacement, bypass or even a heart transplant.

Ask about mini-maze instead.

stopafib.org/mini-maze.cfm

And is your problem so specific that you can't have a normal cryo-ablation instead ?

I had one five years after my bypass and was better the next day.

[Hidden in reply to Mike11]

I have had 4 previous failed ablations all lasting between 4-7 hours all with little to no affect so hence the maze operation is next choice, I shall ask about the mini maze and see what response I get

[Mike11 in reply to Hidden]

sorry to hear that. Hope you find something short of open heart surgery to fix the problem. But Maze doesn't need to stop the heart so at least you won't suffer the memory loss due to the bypass pump.

[Norm]

They did a MAZE on me while having aortic valve replaced and CABG X1. They said I had Afib. Any way MAZE did not work as had Afib when I came out and was on Amiodarone for five months that gave me thyroid problems for which I now have tablets every day for life. You can seach Amiodarone. I did have cardiversion later that worked and I am still thank God in NSR. So may be the MAZE was of some help. Can only suggest as other reply that you investigate and talk to your cardiologist.

[robboian]

Hi Jazz

I inquired about a MAZE procedure about three years ago. After talking to a surgeon who was proposing an open heart (through the sternum) approach I decided against this on the basis of the painful and prolonged recovery. Fortunately I had no other issues that required such a major surgical approach.

I was fortunate to find a surgeon doing minimally invasive ablations through the thoracic wall. A few small incisions in between the ribs, can do external ablations of both left and right sides and modified MAZE procedure. The recovery was painful for a couple of days and then recovery relatively quickly. Might be worth investigating if you don't have other issues requiring such a major opening of your chest.

Ian

[Hidden in reply to robboian]

Hi Ian

Thanks for letting me know this ! Do you mind me asking how old you are / where at time of operation ? Just not sure if it’s very common for someone of my age but hey ho ! Could you possibly let me know what hospital you had the modified maze at ? I’m currently being treated at the royal Brompton London hospital, and I too just have the MAZE operation needed and no other surgery

Thanks again

Jasmin

[robboian in reply to Hidden]

Jazz. I was 62 at the time. Had AF but no other pathology and quite fit. Done at Epworth Box Hill in Australia. Maybe talk to your EP c cardiologist and ask for a referral?

[Hidden in reply to robboian]

Thank you so much for all the info ! I hope you are well now? I am from the UK so I doubt the consultant who did yours would accept a referral from here ?!

[wilen]

Hi. Like Norm above, I had open heart surgery nearly 3 years ago, to have a replacement aortic valve. At the time, I also had permanent afib. I had learned to live with my afib, which didn`t bother me too much, and because the heart valve op was a long one, and with the surgeon not wanting to keep me on by-pass any longer than necessary, I decided not to pursue a maze ablation. However, I did get the surgeon to lop off my left atrial appendage which was a relatively quick job. This considerably reduced my risk of stroke.

Soon after the op, I noticed that I appeared to be in NSR, and it`s been like that ever since. Some aspect of the op seems to have "cured" my afib.

With regard to your worry about the after-effects of the op, My advice is - don`t worry! Apart from a slight ache in the ribcage, which disappeared after a couple of weeks or so, I`ve been completely free of pain and discomfort ever since. At your young age, you should be at a relatively low risk of complications, and if you have a surgeon well versed in this procedure, you shouldn`t have any problems. You`ll soon be back, telling us how well the op went, I shouldn`t wonder. Good luck - look forward to hearing how you got on.

[Hidden in reply to wilen]

Thanks for all the info ! Yes I shall bare all of that in mind, hope you are well now ! I shall let you know how it goes

[AnneWorner]

I've recently had an LAA isolation procedure done by doctor Andrea Natale. He states that MAZE does not stop afib, as he has had patients come to him and they find that the stump left after the MAZE procedure still can produce triggers for afib.

I have my TEE in March to see if the opening from the LAA to the heart has closed after the somewhat aggressive ablation around the opening. If that is successful, I can at least get off the warfarin.

I wouldn't go MAZE knowing what I know now.

[Ianc2]

Hi Jazz

About 4 years ago, age 69, I had open heart surgery to repair my mitral and tricuspid valves, close off my atrial appendage ( with something that looks suspiciously like a mini clothes peg), remodel my heart and carry out a mini maze procedure.

My initial recovery was complicated by my reaction to the anaesthesia used which sent me off with the fairies for a few days. I have since found out that this is a rare but not uncommon reaction and in some cases elderly patients go off with the fairies and don't come back.

My operation was a great success, I could lie in bed and listen to the blood whooshing through my heart. I estimate that my recovery took about 3 months and was a bit painful initially - as in just don't cough.

The Mini Maze did not work but the irregular heartbeat was not as bad. I had an ablation carried out, which did work and all was normal for a couple of years. I went off on a long cruise and picked up a very sore throat. 'Some sort of allergic reaction' my GP said, and prescribed Cetirizine, an anti-histamine which cured my throat. It also has a rare side affect of causing the heart to beat too fast. So I slipped back into a permanent irregular heart beat. Most of the time I am completely unaware of it.

In your case I think that you should have a good chat with an ER before ripping open your chest and find out about ablation possibilities first so that you can make an informed choice.

[Hidden in reply to Ianc2]

Hi, I hope you are all better now ! Sounds like you had a tough time for a while, I am UK bases so assume ER means electrophysiologist ?? Yes I have had 4 previous failed ablations each lasting from 4-7 hours all with very little affect and recurrent symptoms as so I have been out on the list for the MAZE operation, I will definitely ask about some other options though

[Polski]

Have you tried taking magnesium long-term, and possibly a general muli-vitamin-and-mineral tablet for three months? If your body is short of vitamins then ablations are less likely to succeed. Try reading drjohnday.com for example.

[Ianc2]

Hi Jazz

I found your comments regarding the number of ablation attempts fascinating.

I assume you have got your lifestyle options running in your favour e.g, weight under control as in inside your bmi , waist half your height, sugar and chloresterol levels normal, no or very little alcohol/drugs.

Do you take regular exercise? At least 30 mins rapid walking or similar daily or more if you have a sedentary job? As little caffeine as possible and a diet that contains lots of green veg?

Or are you a demented ironman/woman who has reached the grand old age of 35?

In particular are your potassium and magnesium levels good. It is dark and gloomy winter so you vitamin D levels are probably low as well?

[Hidden in reply to Ianc2]

Hi

Yes that’s the end of the ablations through the groin as my EP said that in my case it is like cooking abit of meat ( you have to cook it on one side and then the other ) hence going through a maze operation in hopes of better success! I am only just 18 years old so I have never had a cholesterol tested and I am very slim as I have a very fast metabolism so I’ve been told it is nothing to do with any of that. Definitely not 35 ! I am at college full time and so am active and I do weight training at the gym

[Polski in reply to Hidden]

Try reading 'The Haywire Heart' by Dr John Mandrola and try looking at his website. It sounds as if your exercise regime may be at the bottom of the problem. He is an EP and cyclist, so understands both aspects - the AF and the exercise, and how they affect one another.

[Ianc2]

Get as many tests as you can - if only to rule out possibilities. I had my valves repaired at the Royal Brompton and they did some interesting blood tests, before they dived in, which measured potassium/magnesium/ chloresterol levels, etc, so it may be useful to check with them.

If you are in UNI you may find that they have a sports science department with all sorts of testing / measuring machines that will show you what is going on, especially if you do some gentle aerobic work on a treadmill - as against weights. I take it that you keep an eye on your resting heart rate? However be careful if they mention treadmill stress tests as they tend to crank it up until your heart complains and a few people on here have said that this caused their irregularities to get worse

A certain amount of stress is a good thing but weight lifting can produce blood pressure spikes and raise blood pressure generally, which in turn can cause too much stress and create problems with your heart which can in turn kick off irregularities in you heart beat. Do you measure your maximum heart rates when you are using weights? If you are taking any performance enhancing stuff you may wish to reconsider. You may find getting a fitbit or similar useful to record you heart rate.

As Mike11 said earlier open heart It is not a good experience. You are young and will recover fast but I would try all the lifestyle changes I could and evaluate any alternative approaches that I could and regard this as the last option.

Keep us informed how you get on - we don't get many like you!