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Heart Defect Repair: Before Your Child's Surgery

The heart

What is heart defect repair?

Heart defect repair is surgery to fix a heart problem that prevents blood from flowing normally through the heart. The doctor will make a large cut (incision) in your child's chest. The incision usually is made through the breastbone (sternum) and is called a sternotomy. But some types of heart defects are repaired through an incision in the side of the chest between the ribs and is called a thoracotomy. The doctor will connect your child to a machine that does the jobs of the heart and lungs (heart-lung bypass machine). This machine will allow the doctor to stop your child's heartbeat while the doctor works on the heart.

After the heart is repaired, the doctor will restart your child's heartbeat and disconnect the heart-lung machine. Then the doctor will use stitches to close the incision in your child's chest.

Some heart defects can be repaired with one surgery. But it is possible that your child may need more than one surgery to fix the defect.

Depending on the type of heart defect repair, your child may spend up to a week in the hospital. Your child may need to stay in the hospital longer if they develop any problems after surgery.

How do you prepare for surgery?

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

  • Understand exactly what surgery is planned, along with the risks, benefits, and other options. Ask your child if they have any questions.
  • Tell the doctor ALL the medicines and natural health products 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.
  • Talk to your child about the surgery. It’s important to be honest with them. Tell your child that it will help the heart work the way it should. Hospitals know how to take care of children. The staff will do all they can to make it easier for your child.
  • Before the surgery, you will talk with a member of the anesthesia team about your child having anesthesia. They will talk to you about the different types of anesthesia and the risks and benefits of each type. This may be on the phone or in person.
  • The doctor will ask you to give consent for your child’s surgery. They will also answer any questions you have about your child’s surgery.
  • You will get a tour of the pediatric cardiac intensive care unit (PCICU). This may help to make your child feel less nervous about what happens.
  • Plan for your child's recovery time. They may need more of your time right after the surgery, both for care and for comfort.

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.

Having surgery can be stressful both for your child and for you. This information will help you understand what you can expect and how to safely prepare for surgery.

What happens on the day of surgery?

  • Follow the instructions exactly about when your child should stop eating and drinking, or the surgery may be cancelled. If the doctor has instructed you to have your child take their medicines on the day of surgery, please have your child take the medicine using only a sip of water.
  • See that your child has bathed. Do not apply lotions or deodorant.
  • Your child may brush their teeth. Remind your child not to swallow any toothpaste or water.
  • Be sure your child has something that reminds them of home. A special stuffed animal, toy, or blanket may be comforting. For an older child, it might be a book or music. Leave any valuable items at home.

At the hospital or surgery centre

  • A parent or legal guardian must accompany your child.
  • Your child will be kept comfortable and safe by a member of the anesthesia team. Your child will be asleep during the surgery.
  • Before your child's surgery, the doctors or nurses will ask you to repeat your child's full name and what surgery they're having. This makes sure that the correct part and side of the body will be operated on. The area for surgery may be marked.
  • A small intravenous (IV) tube is usually placed in a vein, to give fluids and medicines. This tube may be placed in the pre-op area or in the operating room after your child is asleep. Because of the medicines given, your child may not remember much about the operating room.
  • After the surgery, your child will be taken to the recovery room or to the PCICU.
  • Before your child wakes up, the doctor will probably talk to you about the surgery. When your child wakes up in the recovery room, the nurse will check their vital signs (temperature, blood pressure, pulse rate, and breathing) and make sure that your child is comfortable. You may be allowed to see your child as soon as they wake up.
  • Your child may have a breathing tube down their throat. This may be taken out a few hours after surgery. In some cases, the doctor may leave it in for a few days.
  • Your child may have a thin plastic tube (called a catheter) in a vein in their neck. It keeps track of how well your child's heart is working. The doctor will probably take it out in 1 to 3 days.
  • Your child will have chest tubes to drain fluid and blood after surgery. The fluid and extra blood are normal and usually last only a few days. The chest tubes are usually taken out within a few days.
  • Your child will have several thin wires (called pacing wires) coming out of their chest near the incision. These wires can help keep your child's heartbeat steady after surgery. They will be taken out before your child goes home.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare your child for the surgery.
  • Your child becomes ill before the surgery (such as fever, influenza (flu), or a cold).
  • You change your mind about your child having the surgery.

Where can you learn more?

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