Minimaze Procedure

What is Minimaze Procedure

Minimaze procedure is a surgery to treat a type of irregular heartbeat called atrial fibrillation. The surgery helps return the heartbeat to normal, which may reduce the long-term risk of stroke and may eliminate the need to take blood thinners.

Atrial fibrillation happens when the heart gets too many signals telling it to beat. During the minimaze procedure, thin lines of heart tissue in the back of the heart where the extra signals come from are destroyed.

Tell a health care provider about:

  • Any allergies you have.
  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any problems you or family members have had with anesthetic medicines.
  • Any blood disorders you have.
  • Any history of smoking.
  • Any surgeries you have had.
  • Any medical conditions you have.
  • Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

  • Stroke.
  • Heart attack.
  • Damage to other structures or organs.
  • Infection.
  • Blood clot.
  • Severe bleeding (hemorrhage).
  • Scarring.
  • Vein or tissue inflammation.
  • Allergic reactions to medicines.

What happens before the procedure?

  • Follow instructions from your health care provider about eating or drinking restrictions.
  • Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
    • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
  • Do not use any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes for as long as possible before your procedure. Try to stop at least 3–6 weeks before your procedure. If you need help quitting, ask your health care provider.
  • Avoid wearing makeup, jewelry, and accessories the day of the procedure.
  • You may have a physical exam.
  • You may have imaging tests.
  • You may be given antibiotic medicine to help prevent infection.
  • Plan to have someone take you home after the procedure.
  • If you will be going home right after the procedure, plan to have someone with you for 24 hours.

What happens during the procedure?

  • To reduce your risk of infection:
    • Your health care team will wash or sanitize their hands.
    • Your skin will be washed with soap.
  • You will be given one or more of the following:
    • A medicine to help you relax (sedative).
    • A medicine to numb the area (local anesthetic).
    • A medicine to make you fall asleep (general anesthetic).
  • Up to four incisions will be made on one side of your chest.
  • A tube with a tiny camera on it will be placed into one of your incisions so that your surgeon can see your heart. Surgical tools will be put into the other incisions.
  • One of the tools will be used to stimulate parts of your heart to see where the irregular signals start.
  • The heart tissue around the area where the signals start will be destroyed.
  • Incisions will be made on the other side of your chest.
  • The same tools will be used to stimulate your heart and destroy heart tissue on this side of your chest.
  • A part of your heart called the left atrial appendage may be closed or removed. This is the part of the heart where blood clots form most often. Closing or removing this part of your heart may reduce your risk of having a stroke.
  • The tools will be removed.
  • A chest tube will be inserted through an incision to drain the surgical area.
  • The remaining incisions will be closed with stitches or staples.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

  • Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
  • You will be given medicines to help relieve pain.
  • Your chest tubes will be watched closely for signs of fluid or air buildup around the lungs. The tubes will be removed when it is safe, and the incision will be closed with stitches or staples.
  • Do not drive for 24 hours if you received a sedative.

Minimaze Procedure, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After your procedure, it is common to feel:

  • Groggy.
  • Nauseous.
  • Tired.
  • Sore.

You may keep having symptoms of an irregular heartbeat for 3–6 months.

Follow these instructions at home:

Activity

  • Avoid activities that use your chest muscles, such as lifting heavy objects, for at least 8 weeks or as long as told by your health care provider.
  • Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
  • Do not travel by airplane for at least 2 weeks after your chest tube is removed, or as long as told by your health care provider.

Driving

  • Do not drive for 24 hours if you received a medicine to help you relax (sedative) during your procedure.
  • Do not drive or operate heavy machinery while taking prescription pain medicine.

Incision care

  • Follow instructions from your health care provider about how to take care of your incision. Make sure you:
    • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
    • Change your dressing as told by your health care provider.
    • Keep the dressing covering the area where the chest tube was inserted dry for 48 hours.
    • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
  • Until the incisions heal, women should wear a soft bra or place gauze pads over the incisions when wearing a wire bra.
  • Do not take baths, swim, or use a hot tub until your health care provider approves. You may take showers.
  • Check your incision areas every day for signs of infection. Check for:
    • More redness, swelling, or pain.
    • More fluid or blood.
    • Warmth.
    • Pus or a bad smell.

General instructions

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Take deep breaths to expand the lungs and to protect against pneumonia.
  • Do breathing exercises as told by your health care provider.
  • If you were given an incentive spirometer to help with breathing, use it as directed.
  • Do not use any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes. If you need help quitting, ask your health care provider.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • Your heart feels like it is fluttering or beating rapidly.
  • You have more redness, swelling, or pain around your incision.
  • You have more fluid or blood coming from your incision.
  • Your incision feels warm to the touch.
  • You have pus or a bad smell coming from your incision.
  • You have a fever or chills.

Get help right away if:

  • You have a rash.
  • You have shortness of breath.
  • You have difficulty breathing.
  • You have chest pain that is not coming from one of your incisions.
  • You feel weak, light-headed, dizzy, or faint.
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