October 24, 2013
Colleen Hamilton

SLUCare cardiac surgeon to present innovative hybrid maze procedure

"The Hybrid Maze: A new approach to treating atrial fibrillation" starts at 6:30 p.m. at the Lodge Des Peres, located at 1050 Des Peres Road, Des Peres, MO, 63131. The lecture is a part of SLUCare's October "For Your Health" fall seminar series, which is open to the public. Light refreshments will be served. Visit slucare.edu/fall to RSVP for this seminar. 

ST. LOUIS – A new approach to treating atrial fibrillation combines the benefits of traditional surgery with the advantages of minimally invasive techniques. Richard Lee, M.D., SLUCare cardiac surgeon, helped develop the new minimally invasive procedure, known as the hybrid maze. 

Richard Lee
Richard Lee, M.D., is a SLUCare cardiac surgeon. 

Atrial fibrillation is a cardiac arrhythmia that affects the upper chambers of the heart, the atria. According to Lee, one in every four people over the age of 45 will develop atrial fibrillation in their lifetime and the possibility increases with age. 

"Atrial fibrillation causes heart failure, but is also the cause of about 25 percent of all strokes in the country," said Lee. The risk of stroke is significantly higher for the elderly who have atrial fibrillation. 

Atrial fibrillation prevents blood in the upper chambers from emptying efficiently, which causes clots to form in the atrial appendage.

"When that clot falls off and goes through the ventricle, it causes a stroke," said Lee. 

The hybrid maze procedure reduces patients' risk of stroke and reliance on anticoagulants by removing the atrial appendage. 

Lee was involved in the development of the original maze procedure, which involved creating small scars in a maze pattern all over the atrium, forcing the current from the upper chamber through a series of scars to the lower chamber.

"At the time, the only way to make the scars was to cut and sew the tissue - which required a sternotomy, opening the heart and stopping it," said Lee. 

The hybrid maze technique improved the original maze procedure through the use of minimally invasive technology. Cameras are used for guidance and allow surgeons to remove the atrial appendage and decrease the patient's risk of stroke. 

"We are no longer relying on the knife to make these scars," said Lee. "We have new technology, like bipolar radio frequency, that freezes tissue and allows us to make these scars without cutting the tissue."

Minimally invasive technology allows surgeons to make small incisions in the chest - about two inches long. 

Lee says this stage of the hybrid maze is very effective in treating symptoms of atrial fibrillation, but one-third of patients need to second stage of the procedure. "In the second stage, cardiologists make lines of scar between the islands that we created and a line of scar down the mitral valve," said Lee. "This gives us the full left side of the maze."

Patients who undergo the hybrid maze benefit from a much faster recovery time because the procedure is performed without opening the heart, while the heart is still beating and without performing a sternotomy. "With minimally invasive surgery, there are really no restrictions because we don't break the breast bones, we just make little windows in the chest," said Lee. 

Lee says that typically patients fully recover from the hybrid maze procedure within two weeks - compared to the two-month long healing process of a sternotomy. 

For more information on the hybrid maze procedure, contact SLUCare's Center for Comprehensive Cardiovascular Care at (314) 977-4440, or visit sluheart.com

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