Post- TT Maze procedure (trans-thoracoscopic Maze ablation)

Thank you Jen! I appreciate the encouragement and sound advice! Pam

Hello all,

I was not used to seeing references to a “TT Maze treatment” (Total Thoracoscopic Modified Maze procedure), so I had to do a little research into what it entails compared to the procedure I had in late 2021. This is a variation of the traditional (older) Maze procedure that was essentially open-heart surgery requiring the use of a heart-lung machine to stop the heart in order to make surgical incisions to the left external atrial chamber. TT Maze instead applies multiple, small incisions to accomplish the same, dismissing the need to stop the heart. Internal ablations (radiofrequency or cryoablation) may be used to “touch up” those remaining pesty electrical signals.

I had the “Convergent” version, which entailed one small incision to reach the heart and using radiofrequency to scar the external heart tissue. This was followed by internal ablation for the same reason I mentioned – so a two-step procedure that “converges” to eradicate AF. Thankfully, mine was a success with no further AF episodes. I think whichever procedure a hospital has adopted, perfected, and meets your individual needs is preferable to endless rounds of medications and cardioversions.

I’ve attached an article that explains either procedure well. There is also a thread under “convergent procedure” with additional info.

Be and stay well!

Happy to hear that the outcome of your procedure has been successful! Thank you for the reference. It affirms what my clinical team shared with me.

Thank you !

Hello Jenrev -
So happy to read of your success with the "less invasive" Maze procedure.
I too am considering the same procedure, due to a persistent thrombus in my appendage.
I had a conference with a well known EP at B&W hospital in Boston. I have had four TEE's, and all of the diagnostics done at a different hospital. After reviewing my history, the B&W EP recommended doing a Watchman, even with the thrombus in place. My reason for this message is I am wondering if you would mind giving me the name of your EP who did the Maze procedure? I am in the process of contacting EP's in Texas, Cleveland Clinic, and Mayo, but B&W would be a lot closer to home. Another question.... did you have an Atrial Apendage Oclusion i.e. arti-clip or similar, during your Maze procedure. Bob

Hi Bob,
I did receive an Atrial Appendage Clip as part of my surgery. No issues with that.

The EP who has continuously been monitoring my case for decades at B&W is Dr. Usha Tedrow.
However, the Maze procedure was actually done by a cardiac surgeon, Dr. Ashraf Sabe, in consultation with a different EP, Dr. Thomas Tadros. I met with Tadros first, who reviewed my case and recommended me to Sabe, who I met later. All of these are top-notch physicians assisted by wonderful medical personnel. Brigham & Women's has an entire cardiovascular building and excellent care and reputation.
Good luck with your search! Jennifer

Jennifer - Thank you very much for your reply.
Just curious...was Dr. Sabe assisted by Dr. Tadros or another EP during the surgery? I have read that the electrical part is done by an EP, and the surgery was done by a surgeon?
Yes, we were impressed by the facility of B&W during our visit.
Bob

Hi again,
I do not know the extent to which Dr. Sabe was assisted by an electrophysiologist. I am a bit of a special case in that I had already had 5 ablations in prior years, which the team believed had created sufficient scar tissue inside the heart that they did not have to (or want to) create any more. This is why I got the Maze surgery only, not the "convergent" that includes atrial ablation. So, it's quite possible that the EP was there to consult only, not to operate.
In any case, one year after the surgery, I can say that it worked. It's not perfect - I have had several short breakthroughs of AFib. This is managed well with "pill in the pocket" Diltiazem that stops the episodes quickly. I am also still taking Flecainide. I am well aware (as a person who has dealt with AFib for nearly 25 years) that my condition could change or degrade in the future. As a doctor once put it, "A-Fib just wants to keep getting worse!" But I am celebrating the best heart health I have had in decades, in this moment.

Hi back at you.

I greatly appreciate you relating your past history. It really does help.
I think 25 years is a long time.
Congratulations!

Bob