Washington Adventist Hospital Performing New Surgical Procedure to Treat Abnormal Heart Rhythm
Minimally Invasive “Mini-Maze” Surgery Has Potential to Eliminate Atrial Fibrillation and Reduce Risk of Stroke -Procedure is Performed for the First Time in the Region
Washington Adventist Hospital has begun performing a revolutionary new type of surgery that can correct atrial fibrillation (AF), a common form of heart rhythm abnormality and a major cause of stroke. The procedure, called The Mini-Maze, offers new hope to AF patients for whom no reasonable cure now exists.
Washington Adventist Hospital is currently the only center in the mid-Atlantic region offering this procedure which is available at only a handful of sites around the country.
Under the direction of Bryan M. Steinberg, MD, a surgical team was able to electrically isolate the parts of the heart responsible for causing AF, restore normal sinus rhythm, and remove the left atrial appendage via a minimally invasive approach. “We are very excited about the Mini-Maze procedure because for the first time we have a safe, reliable, and minimally invasive procedure that can permanently eliminate AF,” said Bryan M. Steinberg, MD. “Given how many patients suffer from the disease, this treatment has the potential to help a very large number of people, significantly reduce their risk of stroke, and improve their lives.”
Huge Impact
According to the American Heart Association, approximately 2.2 million people in the United States suffer from AF and more than 300,000 new cases are diagnosed each year. The condition carries serious consequences. AF increases the risk of stroke fivefold, and is a major contributor to the development of congestive heart failure as well as more serious, life-threatening arrhythmias.
AF is an irregular heart rhythm that interferes with the heart’s ability to pump blood. Abnormal electrical signals begin at the top of the heart and travel down the muscle, causing the atria, or upper chambers, to contract erratically. As a result, blood pools in the atria and forms clots that can travel to the brain and cause stroke. AF is the most common form of arrhythmia, an irregularity in the normal rhythm of the heartbeat.
Novel Procedure with Traditional Techniques
The Mini-Maze procedure involves the use of thoracoscopy, whereby a video telescope is inserted into the chest and instruments specially designed for the procedure are inserted via small ports or key hole incisions. Surgeons are able to burn lines in the heart, isolating areas where the irregular signal starts. The damaged tissue can no longer conduct electrical impulses, interrupting the transmission of the abnormal signal and allowing the rest of the chamber to resume beating normally. In addition the left atrial appendage, a fingerlike structure where clots form, is removed. This significantly reduces the stroke risk faced by patients on a daily basis. Experience to date indicates that Mini-Maze surgery eliminates AF in more than 85% of patients who undergo the procedure.
“By isolating the zone where the arrhythmia originates, we keep the rest of heart from being affected,” Doctor Steinberg explained. “We’ve known for some time that this can be an effective strategy for treating AF, but until now we haven’t had the tools to do it via a minimally invasive procedure.” The procedure takes advantage of standard techniques used in other areas of thoracic surgery but now applied to this effort.
Procedure Improves Treatment Options
AF is now most often treated with anticoagulant drugs, which do nothing to address the abnormal heart beat but instead are used to prevent the formation of blood clots. These clots, which form when blood stagnates and pools in the poorly functioning atria, account for the high risk of stroke in patients with AF. Lifelong anticoagulant therapy is necessary, but these drugs increase the risk of bleeding and require frequent blood tests to ensure that the level of medication is the right range. In addition, medications used to treat AF and regulate both heart rate and control rhythm have significant side effects as well as toxicities, which may be poorly tolerated.
Other treatments, including catheter-based procedures and older forms of surgery, are available to correct the abnormal rhythm of AF but they are difficult to perform and carry increased risk. "With the Mini-Maze procedure, we finally have a dramatic new ability to improve the quality of patients lives for whom there previously were few good options."
Washington Adventist Hospital is a 318-bed, state-of-the-art acute care facility located in Takoma Park, Maryland. Washington Adventist Hospital is Montgomery County's only complete cardiac center, performing 650 open heart surgeries and more than 7,000 heart catheterizations each year.
Washington Adventist Hospital is part of Adventist HealthCare, an integrated health care delivery system based in Rockville, Maryland, that is one of the largest employers in the state of Maryland. Adventist Healthcare includes Washington Adventist Hospital, Shady Grove Adventist Hospital, Potomac Ridge Behavioral Health System, Adventist Rehabilitation Hospital of Maryland, Adventist Senior Living, Adventist Health Careers Training Center, Hackettstown Community Hospital, and Adventist Home Health.