Maze procedure; AVR reop.

[Ron S]

What at great community! Thanks to everyone. I have been reading the posts on aortic valve reoperation and on valve selection. At age 66 I have seven years on a tissue valve and the news that I would require another surgery was very difficult. The posts on this forum are reassuring and encouraging and I think I have made it through the initial low points. I?m more rational and optimistic and able to think through the issues: getting the right doctor, valve selection, timing of surgery, mortality ? rolling the dice. I am leaning toward a mechanical valve, but the decision is not final. Since developing a valve leak in January I have had atrial fib. Coumadin does not seem to be a big deal for me - another operation would be a big deal. I am wondering about the MAZE procedure to correct the A-fib. I am told that this could be done at the time of surgery without additional risk. My concern is extra time on the pump. Anyone have experience with this procedure?

Alan (if you read this), hope your dad is successful. I am so appreciative of the support I have from my family; your caring for him is ?heart warming.? Tough territory. Would like to spare my loved ones the pain and yet they are needed and the biggest reason for rolling the dice.

Hank, if you were ?running interference? for Ross about my registration issues, thanks. You and Ross must be a great team. Ross, if you are doing all the posting, wow! Thanks! What a great field of positive energy!

Best to all,
Ron

 

[Ross]

Hey Ron your welcome. All we ask is that when you get done with your procedure, you come back and offer some help to other scared newbies. Think you can handle that?

 

[Mary]

Ron,
You might PM Patrick Haley and ask him about his Maze procedure experience. I know his a-fib is now under control, but you could ask him the specifics regarding what he had done.
Glad you joined us; we have an old thread running on what type of tissue valve you received and whether you developed afib afterwards. I'd appreciate it if you'd take a look at it and cast your vote. We're trying to keep track of numbers!
Here's the link.
http://www.valvereplacement.com/forums/showthread.php?t=14312&highlight=type+tissue+valve+receive

 

[Ron S]

Maze procedure; AVR reop.

Ross: Can do! I'll be happy to be a member of the community, help when I can and post my other questions. I'm certainly learning the maps of being a "scared newbie" - again! Hope you are making progress.

Mary: I tried to vote, but I was not able to select two choices (tissue and yes, current afib). The button shifted when I made the second choice. I think the afib is the result of an episode of endocarditus combined with the subsequent development of a leak. I was happy with the porcine valve for almost six years. Let me know about voting. I will get in touch with Patrick. Thanks.

Ron S

 

[RCB]

Get ready for research

Get ready for research

Ron,
As one who has had AF for many years I can tell you that the research
on AF is more difficult than on the type of valve you pick. First of all, it is generally agreed by surgeon, that more pump time equals more risk. Secondly, "Maze" is a term which means different things to different people.
The Cox-Maze III is the gold standard of mazes and is not to be confused with the many other procedures that use the word maze in their name.
The rates of success vary greatly by type and surgeon. One important bit of information is, a maze procedure of any type will not be successful if your LA get above 4.5- don't wait, take care of it now.

My advise would be to seek out an AF forum where that is the main
thrust of their concern, because like ACT, their is a lot of bad information
about AF and maze procedures on the net.
Good luck

 

[Cooker]

I had as the surgeon called it "cardiac ablation" my cardio still says "Maze" when he talks about it. This was done along with my AVR. I am not sure what the added pump time was. I had a been on Amiodadone about a year and still had to be cardioverted Anyway, I am off the nasty Amiodarone, Toprol has been reduced to 25mg and all seems well.

I wish you the best. At 50 I went mechanical and have no regrets. Wafarin has been a breeze for me. Like Ross I want to avoid reop at all costs.

Tom

 

[barbwil]

mini maze here

mini maze here

Ron,
I had a mini maze done when I had my mitral valve repaired and the whole surgery was done so fast that my family got very scared when they were called to the phone to speak with the surgeon. Looking back at my surgical notes I see he did the maze first and then the repair. So I think having the maze done did not lengthen the amount of time on the pump appreciatively. Unless my memory is playing tricks on me I think he told me ahead of time that it would add another 15 min.
There is a whole forum just on maze procedures but I haven't been on it for a long time; I'll see if I still can find it.

 

[twinmaker]

Ron, I had A-fib for many years and went through all the medications. I finally had a A-V node ablation. My cardiologists said I wasn't a candidate for the Maze procedure because of the amount of scar tissue from two OHS plus I already had my mechanical valve and they didn't want to mess around with that already implanted. These docs were at Emory in Atlanta. LINDA

 

[Joe Cool]

Hi Ron;

I am 5 weeks out of OHS and had the Maze a.k.a. radio frequency ablation, done at the time of the surgery. I wasn't told that they were going to do it before hand, but I am glad that they did it. I went into a-fib shortly after surgery which they cardioverted with Sotalol. I had several more episodes with a-fib, 2 at the hospital and 2 at home, and each one was less in time and severity. I have not had any more episodes in three weeks. So I feel it works. My cardiologist will take me off of Sotalol after 3 months and said that he may not have to put me on anything else. I don't think that the added pump time was enough to matter. Do your homework and ask lots of questions of your doctors. Good luck!

 

[Ron S]

Maze procedure; AVR reop.

Wow! Great info. I?m still learning the acronyms. RCB, what is LA and how is it measured. Enjoyed your resume. Congratulations! I had afib after the first AVR; then no problems for 5 years. I also had ?pumphead? ? and have some questions about how to manage this interesting post-surgical psychosis. Does everyone have this? My wife told the surgeon not to give me Haldol; he didn?t; I muddled through. Anyway, it seems like the trade off is some additional pump time (risk) vs. the probability of medications which I would rather avoid. And a good probability of success. Nice that you will be off Sotalol, Joe. The scenario you describe rings a bell ? maybe a sound from the future! Barb, if you find the directions to the forum on this topic, I would be interested. Ok. Cox-Maze III is the gold standard. I have the impression that my surgeon will make these decisions when he sees what?s there, but I want to be able to talk to him about the options. All of your posts and this discussion will enable me to do that. Any additional comments, questions, information will be greatly appreciated.

Thanks to all,
Ron S

 

[RCB]

Wow! Great info. I?m still learning the acronyms. RCB, what is LA and how is it measured. Enjoyed your resume. Congratulations! I had afib after the first AVR; then no problems for 5 years. I also had ?pumphead? ? and have some questions about how to manage this interesting post-surgical psychosis. Does everyone have this? My wife told the surgeon not to give me Haldol; he didn?t; I muddled through. Anyway, it seems like the trade off is some additional pump time (risk) vs. the probability of medications which I would rather avoid. And a good probability of success. Nice that you will be off Sotalol, Joe. The scenario you describe rings a bell ? maybe a sound from the future! Barb, if you find the directions to the forum on this topic, I would be interested. Ok. Cox-Maze III is the gold standard. I have the impression that my surgeon will make these decisions when he sees what?s there, but I want to be able to talk to him about the options. All of your posts and this discussion will enable me to do that. Any additional comments, questions, information will be greatly appreciated.

Thanks to all,
Ron S

LA = left atrium, by echo in cm. or mm. Please advised that like valves all doctor do not do all versions of a Maze. Be sure to ask specifically what type he does.
I agree that the trade off is worth it,but some drs. don't want to take the risk, because the outcome is uncertain.

 

[Ron S]

Maze procedure; AVR reop.

RCB. Ok. Thanks. Next is an angiogram and a test to look for an anurism in the abdomen. No hurry. I'm feeling better. Finding things to enjoy!
Ron S