How the Procedure is Performed
How Dr. Affleck Performs the Mini-Maze Surgery
The mini-maze requires small incisions on both sides of the torso for the introduction of the surgical ablation instruments and a visual port. The instruments are introduced into the chest cavity so the ribs don't have to be cracked. Each lung is deflated in turn on each side to ensure the safety and efficacy of the procedure. The surgery takes approximately 4 hours. Most of our Utah Valley patients stay in Timpanogos Regional Medical Center for approximately 3 days.
Dr. Affleck uses the AtriCure Isolator™ Transpolar™ surgical ablation system, and when necessary, cryothermy for additional lesions in patients with permanent-persistent atrial fibrillation.
Dr. Affleck uses the Isolator™ Transpolar™ clamp to create transmural lesions around both the right and left pulmonary veins. This is called Pulmonary Vein Isolation (PVI) and it is the corner stone of every maze procedure. Many studies have shown that the irregular electrical impulses that cause some classifications of atrial fibrillation begin in the pulmonary veins. By creating transmural lesions (meaning lesions that penetrate all the way through the ablated tissue), these irregular impulses are blocked from impacting the heart's normal cardiac conduction cycle.
Dr. Affleck also uses the Isolator™ Transpolar™ pen to map and ablate certain nerve bundles along the heart that have also been shown to cause irregular electrical impulses. These nerve bundles are called ganglonic plexi, and the pen is able to find them, ablate them, and then test them to make sure they are no longer creating electrical impulses.
Finally, Dr. Affleck excises the left atrial appendage. When the heart is not able to pump efficiently, blood can sometimes pool in the left atrial appendage. This blood tends to clot becoming a thrombus. If a piece of the thrombus becomes dislodged and is pumped into the blood stream, stroke can occur. Left atrial occlusion or excision significantly diminishes the potential of thromboembolism and stroke.
Video courtesy of Atricure, Inc.