Re: MAZE complications


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Posted by Steve Giddings on May 03, 2001 at 14:36:17:

In Reply to: MAZE complications posted by Angie on May 03, 2001 at 14:28:58:

I had the maze performed Jan 7, 1999. I was 52 at the time, had paroxysmal af, was in it about half the time and was quite symptomatic, specifically by symptoms consistent with decreased cardiac output. I had been tried on the usual spate of medications and had failed all,including amiodarone, and had a GI bleed while therapeutic on coumadin. Otherwise I had no health problems, including normal blood pressure. Like most of the folks who contribute to this site, I was a chronic endurance competitor (running, cycling and rowing).
For me, the maze was a success. I had a prolonged hospitalization because I remained in a junctional rhythm for 12 days post-op. I had a lot of discomfort at the incision site with persistent tissue swelling lasting about 6 months. I had increased insomnia/decreased sleep requirement after the surgery,which persists.

The only significant complication I had was an episode of sustained atrial flutter that required electrical cardioversion about 6 months ago. This sometimes happens when there is incomplete cryoablation across the coronary sinus, at the back of the heart near the intersection of the left and right atrium. It hasn't recurred, so I haven't done anything about it, but if it recurs even once per year, I will elect to have the site RFA'd. This has been successful in all (reported) cases of late atrial flutter where it has been used.

It took me a long time to reestablish the level of physical fitness I had prior to surgery, but I am there.

In considering Jeanne's remarks, it is very difficult to evaluate her response without knowing a little more about the circumstances of her case. I believe the success rate for the surgery is pretty high, though it is likely somewhat surgeon dependent (as are all surgical outcomes). The procedure itself is technically difficult. This probably explains to some extent why so few centers do it.

My own experience has been that cardiologists are generally against the procedure because they feel it is like killing a fly with a sledge hammer. My own grudgingly admitted that was probably a reasonable option for me.




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