Preparation and Recovery
Once you have been scheduled for a five-box thoracoscopic maze procedure, you will undergo several non-invasive tests. In addition to routine blood work, these include a chest x-ray, a surface echocardiogram and a cardiac stress evaluation (typically a nuclear medicine stress test). Under most circumstances, these tests may be completed during the same day of your appointment. Alternatively, for patients travelling from out of town, any of these tests may be completed at their local hospitals or doctor's office.
All of the pre-operative instructions will be reviewed with you by Dr. Sirak's nurse or nurse practitioner at the time of your visit. They will review your medications and discuss with you when each should be discontinued before surgery. If you have any questions or concerns after your appointment, please feel free to contact our office at (614) 366-7414 and we will be happy to assist you.
Recovering from Surgery
After surgery, you will be cared for in one of the beautiful, state-of-the-art, private rooms in the Richard M. Ross Heart Hospital. Depending on your recovery, you will stay in the hospital for 1 to 2 days. Each room is comfortably arranged to include a pull-out sofa and private bathroom so that your loved ones can stay with you. We value and embrace family participation in every aspect of your care.
Upon discharge from the hospital, you will have no activity restrictions. However, it is recommended you do not drive for 2 to 3 days after discharge to ensure the anesthesia is completely worn off. Provided you are feeling well, you should be able to return to work in approximately 5 to 7 days.
At discharge, you will be scheduled to see Dr. Sirak in the outpatient clinic one month after surgery. This is a standard follow-up to ensure normal post-operative recovery and wound healing. Dr. Sirak or his nurse will review with you the plan for follow-up and heart monitoring for the next year after surgery. You can expect to receive a remote heart monitor from CardioNet® at 3, 6, and 13 month intervals after surgery to assess your rhythm status.
CardioNet will mail the monitor to your home to minimize any inconvenience to you, and after completing the 7 day heart monitoring, you mail the monitor back in the packaging provided. CardioNet offers the most state-of-the-art monitoring devices with advanced arrhythmia detection algorithms, and the monitors are also self-actuated, meaning they automatically record any abnormal rhythms without requiring the patient to trigger a recording.
As for medications after surgery, all patients, unless otherwise contraindicated, will continue on warfarin for 3 months until rhythm stability is documented with the CardioNet device. Warfarin is then stopped in most cases unless a specific medical condition mandates its continuation. Rhythm-control medicines are not routinely used after the five-box thoracoscopic maze procedure. In a small (about 20%) percentage of patients, early relapses of atrial fibrillation may occur. These early recurrences represent perioperative inflammation causing temporary irritability of the heart's conduction system. This inflammation subsides typically within a month of the operation. All early recurrences are treated with anti-arrhythmia medicines until this temporary inflammatory period passes.
More Information
For more details about atrial fibrillation treatment, including the five-box thoracoscopic maze procedure, request a phone consultation with Dr. Sirak or call his appointment phone at (614) 366-7414.