18 Innovations: First Combined Maze and Mitral Valve Procedure

Marrying procedures to treat atrial fibrillation


Cleveland Clinic isn’t first in everything. For instance, Cleveland Clinic surgeons didn’t do the first Maze procedure for the surgical treatment of atrial fibrillation. That was done by its developer, James Cox, MD, at Barnes-Jewish Hospital in 1987. But Cleveland Clinic did do the second, and later the first Maze and mitral valve procedure in the same operation (1991).

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A Maze procedure treats atrial fibrillation (a heart rhythm disorder) by disrupting the flow of nerve impulses down the surface of the heart.  It does this by placing a series of deep incisions down the atria in a pattern that appears somewhat maze-like. The “classic” Maze is performed through a major chest incision with cardio-pulmonary bypass. A minimally invasive or “keyhole” Maze can also be done. Cleveland Clinic performs about 500 Maze procedures a year, most of them in combination with mitral valve replacement or repair, or other cardiac procedures.

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