Open heart defect surgery

A congenital heart defect is a problem with how a child's heart formed. The defect can affect how blood flows through the heart or blood vessels. The heart may have a hole between its chambers. A valve or artery may not have formed the right way. Or a heart valve, artery, or chamber may not have formed at all.

The type of surgery your child has will depend on the type of defect.

Your child will be asleep during the surgery. The doctor will make a cut in your child's chest. This cut is called an incision. It may be made through the breastbone. Or it may be in a different place. Some types of heart defects are repaired through an incision on the side of the chest between the ribs. During the surgery, the doctor may connect your child to a machine that does the jobs of the heart and lungs. This is called a heart-lung bypass machine. It will allow the doctor to stop your child's heartbeat while the repair is done. If this machine is used during surgery, the doctor will restart your child's heartbeat and stop the heart-lung machine after the defect is repaired.

After the doctor repairs the defect, stitches or staples may be used to close the incision in the chest.

Your child may stay at least a few days in the hospital.

Having a child with a heart problem can be scary. You may feel overwhelmed. Learning as much you can about your child's treatment can help you feel better. You may also want to talk with other parents who have a child with similar problems.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Activity

• Have your child rest when your child feels tired.
• For 3 months, make sure your child avoids lifting anything that would make your child strain. This may include a heavy backpack, heavy grocery bags and milk containers, or bags of cat litter or dog food.
• Have your child hold a pillow over the incision when your child coughs or takes deep breaths. This will support your child's chest and decrease the pain.
• Have your child do breathing exercises at home as instructed by your doctor. This will help prevent pneumonia.
• For 4 to 6 weeks or until the doctor says it is okay:
  • Your child should not ride a bike, play running games or contact sports, or take part in gym class. It is okay for your child to walk and play with other children or play with toys.
  • Your child should not do activities that could cause a blow to the chest, such as wrestling or playing catch with a ball.
  • Do not pick up your child by the arms. This can put stress on the chest incision. Scoop up your child by putting your arms under your child's rear end.
• Your doctor will tell you when your child can go back to school or day care. Your child will probably have to spend at least 1 week at home.
• For about 1 week, keep your child away from large crowds and people that you know have a cold or the flu. This lowers your child's chance of getting an infection.

Diet

• Your child can eat a normal diet. If your child's stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• If your child's bowel movements are not regular right after surgery, you can help your child avoid constipation and straining. Have your child drink plenty of water. The doctor may suggest fiber, a stool softener, or a mild laxative.

Medicines

• Your doctor will tell you if and when your child can restart any medicines. The doctor will also give you instructions about your child taking any new medicines.
• Have your child take medicines exactly as prescribed. Call your doctor if you think your child is having a problem with a medicine.
• Be safe with medicines. Read and follow all instructions on the label.
  • If the doctor gave your child a prescription medicine for pain, give it as prescribed.
  • If your child is not taking a prescription pain medicine, ask the doctor if your child can take an over-the-counter medicine.
• If you think the pain medicine is making your child sick to the stomach:
  • Have your child take the medicine after meals (unless the doctor has told you not to).
  • Ask your child's doctor for a different pain medicine.
• If your doctor prescribed antibiotics, be sure your child takes them as directed. Your child should not stop taking them just because your child feels better. Your child needs to take all the antibiotics.
• If your child takes a blood thinner, be sure to get instructions about how to give this medicine safely. Blood thinners can cause serious bleeding problems.

Incision care

• Your child will have a dressing over the cut (incision). A dressing helps the incision heal and protects it. Your doctor will tell you how to take care of this.
• If your child has strips of tape on the cut (incision) the doctor made, leave the tape on for a week or until it falls off.
• Change the bandage every day.
• Wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol. They can slow healing.
• Your child may shower 24 to 48 hours after surgery, if the doctor okays it. Pat the incision dry. Your child should not swim or take a bath for the first 2 weeks, or until your doctor tells you it is okay.
• Do not use any creams, lotions, powders, ointments, or oils on the incision unless your doctor tells you it is okay.

Other instructions

• Keep track of your child's weight. Weigh them every day at the same time of day, on the same scale, in the same amount of clothing. A sudden increase in weight can be a sign of a problem with their heart. Tell your doctor if your child has a sudden weight gain in 2 to 3 days. Your child's doctor can tell you how much weight gain to watch for.
• Heart defects can increase your child's risk of an infection in the heart. Talk to your doctor about your child's risk. Your child may need to take antibiotics before certain dental or surgical procedures to prevent infection. Help your child take good care of their teeth and gums to help prevent infection.