Operative tissue ablation and reconstruction of atria, extensive (eg, maze procedure); without cardiopulmonary bypass
CPT4 code
Name of the Procedure:
Operative Tissue Ablation and Reconstruction of Atria, Extensive (e.g., Maze Procedure); Without Cardiopulmonary Bypass
Summary
The Maze procedure is a surgical intervention to correct irregular heartbeats, such as atrial fibrillation. This specific version is performed without the use of a cardiopulmonary bypass machine.
Purpose
The Maze procedure aims to treat atrial fibrillation by creating a 'maze' of new electrical pathways in the atria to ensure that the heart beats regularly. The outcome is expected to restore normal heart rhythm and improve heart function.
Indications
- Persistent or long-standing atrial fibrillation not controlled by medication or other interventions.
- Symptoms such as palpitations, shortness of breath, fatigue, or increased risk of stroke due to atrial fibrillation.
- Patients who are good candidates for surgery based on overall health and heart function.
Preparation
- Patients may need to fast for a few hours before the procedure.
- Medication adjustments, particularly anticoagulants, might be needed.
- Pre-procedure assessments may include an ECG, blood tests, and imaging studies of the heart.
Procedure Description
- Anesthesia: General anesthesia will be administered.
- Incision: A small incision is made in the chest.
- Ablation: Surgeons use specialized tools to create scar tissue in the atria, effectively blocking the abnormal electrical impulses causing atrial fibrillation.
- Reconstruction: Any damaged tissue is repaired.
- Closure: The incision is then closed with sutures or staples.
Duration
The procedure typically takes between 3 to 4 hours.
Setting
This surgery is performed in a hospital's cardiovascular operating room.
Personnel
- Cardiothoracic surgeon
- Anesthesiologist
- Surgical nurses and technicians
- Cardiologist (for pre- and post-operative care)
Risks and Complications
- Bleeding
- Infection
- Stroke
- Damage to heart tissues or valves
- Irregular heartbeats post-surgery
- Blood clots
- Respiratory complications
Benefits
- Restoration of normal heart rhythm
- Improvement in symptoms like fatigue and breathlessness
- Reduced risk of stroke and other complications associated with atrial fibrillation
- Improved overall heart function
Recovery
- Initial recovery in the hospital for monitoring, typically for a few days.
- Pain management with medications.
- Limited physical activity for several weeks.
- Follow-up appointments to monitor heart function.
- Long-term medications may still be needed to maintain normal rhythm.
Alternatives
- Medications: Anti-arrhythmic drugs or anticoagulants.
- Catheter Ablation: A less invasive procedure using catheters to ablate the faulty electrical pathways.
- Electrical Cardioversion: Using electric shocks to reset the heart rhythm.
- Left atrial appendage closure to reduce stroke risk.
Patient Experience
During the procedure, patients will be under general anesthesia and will not feel any pain. Post-procedure, patients may experience some chest discomfort and be groggy from anesthesia. Pain management and comfort measures will be provided. Complete recovery can take several weeks, during which time patients will need to monitor their symptoms and follow their doctor's instructions closely.