What is 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.

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.

Surgery can be stressful for both your child and you. This information will help you understand what you can expect. And it will help you safely prepare for your child's surgery.

Preparing for surgery

• Talk to your child about the surgery. Tell your child that the surgery will help your child's heart work better. Hospitals know how to take care of children. The staff will do all they can to make it easier for your child.
• Ask if the hospital has child life specialists. They can help you and your child understand your child's health condition, prepare for the surgery, and get emotional support.
• Ask if a special tour of the surgery area and hospital is available. This may make your child feel less nervous about what happens.
• Plan for your child's recovery time. Your child may need more of your time right after the surgery, both for care and for comfort.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• Tell the doctor ALL the medicines, vitamins, supplements, and herbal remedies your child takes. Some may increase the risk of problems during the surgery. Your doctor will tell you if your child should stop taking any of them before the surgery and how soon to do it.

The day before surgery

• A nurse may call you (or you may need to call the hospital). This is to confirm the time and date of your child's surgery and answer any questions.
• Remember to follow your doctor's instructions about your child taking or stopping medicines before surgery. This includes over-the-counter medicines.

A congenital heart defect is a problem with how a child's heart formed. The doctor repaired your child's heart defect through a cut, called an incision, in the chest.

You can expect the incision to be sore for a few weeks. The doctor will teach you how to take care of your child's incision. It will leave a scar that will fade with time.

Your child will probably feel more tired than usual for several weeks after surgery. Your child may be able to get back to doing many usual activities after 4 to 6 weeks. But it may take up to 2 to 3 months for your child to fully recover. How long it takes may depend on the type of heart defect your child had.

Surgery to repair a congenital heart defect can be stressful for you and your child. Some children find that they feel sad or more emotional while they are recovering after this surgery. This may last for up to 6 weeks after surgery. Talk with your doctor if this sadness continues or you have concerns about how your child is feeling.

• Follow the instructions exactly about when your child should stop eating and drinking. If you don't, the surgery may be canceled. If the doctor told you to have your child take any medicines on the day of surgery, have your child take them with only a sip of water.
• Have your child take a bath or shower before you come in. Do not apply lotion or deodorant.
• Your child may brush their teeth. But tell your child not to swallow any toothpaste or water.
• Do not let your child wear contact lenses. Bring your child's glasses or contact lens case.
• Be sure your child has something that's a reminder of home. A special stuffed animal, toy, or blanket may be comforting. For an older child, it might be a book or music.

At the hospital or surgery center

• A parent or legal guardian must accompany your child.
• Your child will be kept comfortable and safe by the anesthesia provider. Your child will be asleep during the surgery.
• The surgery may take at least several hours. The amount of time that the surgery will take depends on the type of operation needed.
• After surgery, your child will be taken to the ICU or a recovery room. As your child wakes up, the staff will monitor your child's condition. The doctor will talk to you about the surgery.
• Your child may have a breathing tube down the throat. This may be removed a few hours after surgery. Or the doctor may leave it in place for a longer time.
• Your child may have a thin plastic tube in a vein in the neck. This tube is called a catheter. It is used to keep track of how well your child's heart is working. The doctor will probably take it out in 1 to 3 days.
• Your child may also have a catheter in an artery in the arm. It is used to check blood pressure and take blood samples.
• Your child will have chest tubes to drain fluid and blood from the chest after surgery. The fluid and extra blood are normal and usually last only a few days. The chest tubes are usually removed in 1 or 2 days.
• There may be one or more thin wires coming out of your child's chest near the incision. These wires can help keep your child's heartbeat steady after surgery. They will be removed before your child goes home.
• Your child may have a tube that drains urine from the bladder. This is called a urinary catheter. It is usually removed within 1 day.
• Your child may have a thin plastic tube in the nose that goes down the back of the throat into the stomach. It will drain stomach juices. It is usually removed in the days after surgery.