I am scheduled to have open heart surgery (OHS) to replace my aortic valve and while my chest is open the surgeon said they believe it would be a good time to perform a Maze ablation for my persistent afib. FYI: I was diagnosed with afib and tach back in 2008 - both were controlled well with flecainide until this past winter when I got Covid. Anyway, is the Maze procedure fairly effective? Is it the only method available during OHS? How does it compare to other methods? I had RF ablation in 2018 that only lasted 9 months.
Thanks in advance.
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Jafib
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Until the invention of catheter ablation a maze was the only intervention available. Catheter ablation was invented to make the process more easliy accessible to more people; .I think one can consider it effective.
the surgeon said they believe it would be a good time to perform a Maze ablation for my persistent afib.
Your surgeon is 100% correct.
The Maze is the gold standard with the best results for atrial fibrillation.
The only reason it's not used more often is because it usually involved more invasive traditional open heart surgery. In your case, you're already having open-heart surgery, so that is not an issue.
Hopefully you can expect a very good result for your atrial fibrillation.
Maze must better than Pulse Field Ablation (PFA) in your case. Better results and would not involve going though the groin as it's catheter based. PFA results similar to RF and Cryo. Maze has better results.
Arguably the gold standard in catheter ablations, but Maze is gold standard overall. The only reason it isn't used more is because it's a more invasive procedure, but since the OP is already having open heart surgery, that is not an issue.
The only way you can get the maze procedure is if you are already having OHS. It is the most effective way of curing afib.
I am pretty certain that there are no other options for afib during OHS.
I would certainly jump at the chance of the maze, if undergoing OHS. It is the best treatment that you can get for afib. Certainly beats any type of ablation.
Cardiologists don’t have the same level of success with their toolbox of ablations. This is on another level. Go for it.
The only way you can get the maze procedure is if you are already having OHS.
The latest version of the maze is Cox Maze IV. It can be performed with and without opening the sternum and a heart lung machine.
Because of this, the version without opening the sternum is being offered by major centers (at least in the US) as a standalone procedure for afib and is considered minimally invasive surgery.
This is not to be confused with the Wolff Mini Maze -- also minimally, invasive heart surgery for afib -- that does not do the complete Cox lesion set, but focuses more on the pulmonary veins.
Hello Mav7. I discussed TAVR with the docs, however, there are a couple reasons it is not recommended at my age (55): First, the valve in your aorta is not round, it is more oblong, I believe, which may cause fit issues with the inserted bio valve (bio valve is round). Now, of course, that is not always an issue or even an issue much of the time or they would not perform TAVR regularly. The second concern is that if I had TAVR now at 55 that the valve would likely wear out before I would die of other causes and would then require OHS at an older age, which could be riskier at that time - especially if the bio valve lasted 20+ years. The reason OHS would be required at that time is that they would probably not want to place a TAVR valve inside another TAVR valve - it would have to be quite small.
There was no mention of the bicuspid valve or its stenosis having any relation to my afib.
It is certainly a different ballgame at age 77, however, I wouldn't completely rule out open heart surgery - Barbara Walters had her aortic valve replaced via open heart at age 80! Personally, however, if I had my original valve, I would probably lean toward TAVR if I were 77. Another thought, if you are only at moderate stenosis at age 77, you may never progress to severe...
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Ablations might differ depending on method and technology 
Effects after ablation here I go again
Duration of effectiveness of ablation in preventing episodes in Paroxysymal AF
How long is recovery after ablation and what are the effects?
after effects of PVC Ablation 
