Is this enough Maze Procedures from a Doctor

I know it's critical to know how many (similar or identical to your) procedure a doctor has done. From my understanding, many hundreds is ideal and really in the thousands is far better. Someone like Dr. Natale whose done thousands of ablations is one of the most referred here because of his track record on that number. With that said I have mitral valve repair surgery as well as a Maze Procedure and Want to ensure I get the best surgeon for bOTH procedures. My Surgeon has done over 500 successful Mitral Valve Repairs similar to mine. However, they have done only
100 or so Maze procedures. It seems to me like that is a low number but I also know there are a lot less maze procedures as opposed to ablations as a doctor isn't going to do a maze procedure unless there is another underlying condition to correct as there is in my case with the Mitral Valve.

With this said, does the number of 100 Maze Procedures seem low?



Edited 1 time(s). Last edit at 03/07/2024 12:58AM by cornerbax.

It looks like this double posted. Carey, can you delete the Duplicate please? Thanks



Edited 1 time(s). Last edit at 03/07/2024 12:59AM by cornerbax.

Definitely apples and oranges, but my knee jerk reaction is 100 is enough. However, if it were me, I'd do a bit of due diligence, including calling a few top ten cardiac hospitals and compare numbers.

Jim

A little more info: my Doctor does the vast majority of their valve repairs specific only to the mitral valve. They've done about 500 Mitral Valve Repairs with a 99%+ success ratio. Apparently, only 1 in 6 people who get their Mitral Valve repaired also need to correct Afib and get a Maze Procedure at the same time. This is why they've done far fewer Maze Procedures. 100 certainly doesn't seem bad or necessarily low, but the other factor that I'm a little confused about is that the Thoracic Surgeon who would be doing my Mitral Valve Repair, would also be the same surgeon doing the Maze Procedure.

I was under the impression an electrophysiologist would be best suited for a Maze Procedure or anything to do with the "electrical" aspects of the heart. I do have an EP from the same Hospital (Cedars-Sinai) who basically didn't seem to be too concerned with the Thoracic Surgeon also conducting the Maze Procedure. Again, I was still a little perplexed as I thought you'd want a specialist on every aspect of your heart. Anyone have any thoughts on this?



Edited 2 time(s). Last edit at 03/07/2024 01:00AM by cornerbax.

Quote
cornerbax
I was under the impression an electrophysiologist would be best suited for a Maze
procedure or anything to do with the "electrical" aspects of the heart. I do have an
EP from the same Hospital (Cedars-Sinai) who basically didn't seem to be too concerned
with the Thoracic Surgeon also conducting the Maze Procedure.

A maze requires a surgeon, which the EP is not. EP procedures are vastly different than actual heart surgery. A thoracic surgeon makes sense for a maze procedure.

Ep's do not do Maze or mini maze. You need a cardiothoracic surgeon.

Jim

Quote
Ep's do not do Maze or mini maze. You need a cardiothoracic surgeon.

This now makes sense. I guess I kind of considered ablations a level of surgery, but apparently they are not and certainly not open heart surgery. At this point, I have done my due diligence and spoken with the Thoracic Surgeon on a couple of occasions. I am very big on going with my instincts (even over my research) and both in this case were excellent. I feel like I am in the best hands and I'm not calling anybody else at
Cleveland Clinic, or Mayo, etc, as I feel my Thoracic Surgeon would be the best option for me. I was extremely comfortable meeting them the first time and their level of patience in answering each of my questions very thoroughly. I just didn't know if ~100 Maze Procedures seemed on the higher or lower side, but it definitely isn't like 5 or 10, right? lol



Edited 1 time(s). Last edit at 03/07/2024 01:02AM by cornerbax.

I think 100 is sufficient. A Maze procedure is vastly different than an ablation and doesn't require the same delicate nuance of art and science that an ablation does, which is why having done thousands of afib ablations is important when choosing an EP.

Quote
I think 100 is sufficient. A Maze procedure is vastly different than an ablation and doesn't require the same delicate nuance of art and science that an ablation does, which is why having done thousands of afib ablations is important when choosing an EP.

Thank you. I'm just hearing and reading different things regarding the chances of being completely free of AFIB after
the Mitral Repair, closing off the LAA and the Maze. I was told it's as high as 85% I wouldn't have any more AFIB
or AFLUTTER after the surgery is complete, at least long-term after the healing process. I'm reading some stats as
low as 60-65%. Either way, I guess those are good enough numbers to definitely have this done and hope that
I need nothing more after.

The difference in stats is dependent on the sample. If the person reporting uses samples of results from the top 50% of reporting administrators, then the predicted success is likely to be on the high side. If a much wider, and more inclusive, sampling is done, you're going to see a drop in the predicted success rate because many more failures will be included in the sample.

Remember, too, that a second stab at it, in case the first procedure fails, is going to be in the 80% range because often the mistakes from the first round are more easily determined and spotted. So, if you are in the minority of cases where the first procedure fails, a second is going to have a higher rate of success, and that's across the board, or more so. Obviously, the very best EPs are going to do somewhat better due to their skill and experience.

@ gloaming,

makes perfect sense. At the end of the day hopefully i'll be in the success rate stats, but if not, as you said, an ablation afterwards, at some point to hopefully get close to the 100% would be the next move.



Edited 1 time(s). Last edit at 03/07/2024 01:02AM by cornerbax.

I would just like to say good luck to you, cornerbax. I hope everything goes well and wish you a speedy recovery.

Of course no one chooses open heart surgery solely to treat afib, however, the silver lining is that a maze procedure should be superior to any catheter ablation, regardless of how experienced the ep. Best of luck.

Jim



Edited 1 time(s). Last edit at 01/24/2024 10:56AM by mjamesone.

@Mark,

thank you. I always appreciate your kind words. The surgery is scheduled for beginning of June, I will update in a few months as it gets closer. Thanks, Mark.


@ Jim,

I agree that is the silver lining is that the Thoracic Surgeon is right there to do the Maze Procedure. I'm definitely not jumping for joy on having this surgery, I'm sure nobody does. The reality though is without the surgery sooner vs. later is that I'll have all kinds of complications and can likely get to the point of no return. If my Left Ventricle starts to enlarge and/or EF drops too low, the reality would be potential instant death. This is just a reality of Life and in my case, I have to get it done for my son and my family. Thanks for all the helpful info, it's very much appreciated.



Edited 1 time(s). Last edit at 03/07/2024 01:03AM by cornerbax.