The Wolf Mini-Maze

Using the Wolf Mini-Maze procedure to change the way your heart conducts electrical impulses, solving issues with an irregular heartbeat and the associated stroke risk, is still relatively new. While Dr. Wolf has done the procedure thousands of times, he was also the first one to invent it after the initial Maze procedure was created back in 1987.

The issue with those earlier surgeries was that they required you to be hooked up to a heart-lung machine. Recovery could take a week or more. It was a massive, invasive surgery. It worked, but it was riskier and more difficult. The atrial fibrillation mini-maze surgery changed everything by taking the next logical step and getting the same results in seconds, with a minimally-invasive procedure that gives you all manner of advantages.

The “Mini-Maze” Developed by Dr. Randall K. Wolf

The “Mini-Maze” was developed by Dr. Randall K. Wolf, Professor of Cardiothoracic Surgery and Director of the Center for Surgical Innovation at the University of Cincinnati., using instruments that he helped design. Dr. Wolf’s procedure combines an “ablation” method and the “maze” procedure, WITHOUT performing “Open heart surgery.”

Dr. Wolf developed this new minimally invasive procedure to treat AFib without making a seven inch incision in the sternum or breastbone and without having to use the heart-lung machine. The mini-maze procedure is a much less invasive procedure, in which he enters the chest through small incisions between the patient’s ribs.

Procedural Video

Dr. Wolf performs in fact two surgical procedures at one time. He uses a special “bi-polar” RF clamp to ablate and electrically isolate the pulmonary veins, where the triggers are located that activate AF. This ablation procedure is performed through two small “non-rib-spreading” mini-incisions, one on each side of the chest. The word “ablation” simply means to destroy tissue by burning it. This is done in a specific pattern. The chaotic electrical activity of the heart is halted because the electrical impulses cannot cross the burn scars that separate the areas of the atria. The “bi-polar” RF clamp is so efficient that he can perform an ablation in 8 seconds. An ablation would normally take up 3 minutes with a conventional unipolar RF head.The second part of the procedure is the endoscopic exclusion of the left atrial appendage, a useless “thumb-like” structure of the heart that can host clot formation that can lead to a stroke. 

Strokes due to AF are particularly devastating.

The devices are navigated by a micro-miniature television camera, so that Dr. Wolf can actually see the heart without opening the chest. The procedures performed at the University of Cincinnati were specifically focused on treating AFib as a stand-alone condition. The new less invasive procedure allows patients who have suffered from long-standing intermittent AF to undergo a less invasive surgery to treat their AFib and recover faster than traditional surgery for AFib. Patients who undergo this procedure are expected to have hospital stays of only 2-3 days, compared to 7 days or more with conventional surgery. 

A Next-Level Approach

One advantage of the Mini-Maze procedure for AFib is that it changes the way doctors approach lesions, shifting to a minimalist approach. This can make the procedure more effective than ever before. It’s also far faster than previous procedures. 

The key to the atrial fibrillation mini-maze surgery lies in the dry radiofrequency technology. It is also made possible due to the ability to get the clamp inside without going through the breastbone. The use of cameras allows for stunning pictures that give Dr. Wolf the ability to carry out the procedure without opening the chest. 

Does the Wolf Mini-Maze procedure work? It’s been wildly successful. From the very beginning, the promise was clear. Now, Dr. Wolf has patients he sees every year, and he has studied some of them for weeks to make sure they do not have AFib. A decade after the procedure, they still don’t. They don’t take medication, they don’t need secondary procedures, and they don’t live with that constant stroke risk.