place of abode Study Program THE ...

place of abode Study Program

THE MAZE III SURGICAL PROCEDURE

The article "The maze III surgical procedure" is the basis for this AORN Journal independent consideration The behavioral objectives and examination for this program were prepared by dint of Rebecca Holm, RN, MSN, CNOR, clinical editor, with consultation from Susan Bakewell, RN M education program professional, Center for Perioperative Education.

A minimum score of 70% upon the multiple-choice examination is necessary to cam 3 contact hours for this independent research Participants receive feedback on incorrect answers. Each applicant who favorably completes this study will receive a certificate of completion. The deadline for submitting this investigation is July 31, 2005.

cast the completed application form, multiple-choice examination, learner evaluation, and appropriate fee-simple to

AORN Customer Service c/o dwelling Study Program 2170 S Parker Rd Suite 300 Denver CO 80231-5711

or fax the information with a credit card number to (303) 750-3212

BEHAVIORAL OBJECTIVES

After reading and studying the article in succession the maze III surgical management the nurse will be able to

(1) explain the rationale for performing the maze III surgical process on the ideal surgical candidate,

(2) identify preoperative preparation specific to the patient undergoing the maze III procedure

(3) describe cryosurgery

(4) discuss the paces of the maze III surgical transaction and

(5) describe the postoperative phase of a patient undergoing the maze III surgical procedure

This program fittings criteria for CNOR and CRNFA recertification, as well as other continuing education requirements.

In the healthy heart, electrical impulses travel the same primary route through the heart; however, secondary paths are available should the primary passage become obstructed by injury or disease. Abnormal heart periodical emphasiss such as atrial fibrillation (A fib), can arise when electrical impulses travel via an aberrant pathway. The heart may re-create to A fib without underlying heart disease, if it were not that the probability of A fib increases dramatically when cardiovascular disease is near Atrial fibrillation also can come to pass in conjunction with noncardiovascular point in disputes (1)

After A fib becomes symptomatic, it typically is associated with significant morbidity related to reduc cardiac output As the patient's cardiac output diminishes, line pools in the atria, resulting in the formation of offspring clots. Blood clots in the left atrium can dislodge and travel by the and of the blood stream to the brain, resulting in shock and even death. (2) Atrial fibrillation is the mostly common type of arrhythmia.

The maze management was designed to create a maze onward the atria with multiple incisions that allow sinus periodical emphasis to be conducted to the atrioventricular node without creating a reentry circuit. (3) The barriers force the electrical impulse to travel from the top of the heart to the bottom via merely one major route. This act is designed to cause A fib to die on the outside and not be transmitted to the ventricle. (4) Eliminating aberrant pathways interrupts A fib and its potentially devastating effects

ANATOMY AND PHYSIOLOGY

The heart is a muscle that functions primarily as a double-sided cross-question The left side pumps oxygen-rich progeny to all parts of the dead body The right side of the heart cross-questions blood from the body back to the lung to be reoxygenated. The heart has four chambers. The sum of two units upper chambers are the right and left atria. The sum of two units lower chambers are the right and left ventricles. The left ventricle is the strongest chamber of the heart. It cashiers blood into the aorta (ie, the main supplier of oxygenated offspring to the entire body). Heart valves (ie, aortic, mitral, tricuspid, pulmonary) that passively unclose and close to direct the result of blood separate the upper and lower chambers and the aorta.

Electrical stimulation causes the heart muscles to contract or cross-question During a normal heartbeat, an electrical impulse originating in the right atrium travels simultaneously to the left atrium and down the intra-atrial septum to the atrioventricular node. The impulse continues to travel down a universal pathway splitting into the left and right set off in a hurry branches located in both ventricles. This round of years of electrical stimulation is known as normal sinus periodical emphasis (NSR). In A fib, the tissue in the atria beats chaotically and ineffectively. family remains in the atria too extended sometimes causing the formation of family clots, which may lead to a life-threatening hit (5)

Atrial fibrillation is imagination to be the result of macro reentry in the atria (Figure 1) The maze management therefore, is necessary to hinder possible reentry from occurring. (6) Macro reentry is defined as a storm of electrical activity that travels in spinning wavelets (ie, macro reentrant circuit) across the two atria, causing these upper chambers to quiver or fibrillate 300 to 600 times by means of minute. (7)

[FIGURE 1 OMITTED]

SYMPTOMS AND TREATMENT OPTIONS

Medication, electrical cardioversion, ablation to take away or destroy the function of united or more electrical impulse center in the heart, pacemaker implantation, or surgery are the usual treatment options for A fib. The surgeon identifies an individualized treatment course based in succession the patient's symptoms and his or her class of disability. (8) After other treatment options are exhausted, the maze III surgical conduct is considered. The three major goals of treatment include: