What is surgery to repair a congenital heart defect?

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, or 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.

The doctor will make a cut (incision) in your child's chest. The incision usually is made through the breastbone. But 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 (heart-lung bypass machine). This machine will allow the doctor to stop your child's heartbeat while the repair is done. If a heart-lung bypass machine is used during surgery, the doctor will restart your child's heartbeat and stop the heart-lung machine after he or she fixes the defect.

After the doctor repairs the defect, he or she will use stitches or staples to close the incision in the chest.

Your child will probably spend about 1 week in the hospital. The amount of time your child needs to recover depends on the type of surgery he or she had.

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.

Follow-up care is a key part of your child's treatment and safety. Be sure to make and go to all appointments, and call your doctor if your child is having problems. It's also a good idea to know your child's test results and keep a list of the medicines your child takes.

What happens before surgery?

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.

Preparing for surgery

• Bring a list of questions to ask your child's doctors. It is important that you understand what surgery is planned, the risks, benefits, and other options.
• A simple explanation should be given to your child before the surgery. Depending on your child, this should be done a day or two before surgery for children age 5 years and younger, and up to a week before surgery for older children.
• Tell your child's doctors ALL the medicines, vitamins, and natural health products your child is taking. Keep a list of these with you, and bring this with you to your child's appointments. You will be told which medicines to give your child before surgery.
• Tell your doctor or nurse about any allergies your child has to medicines or latex.
• Some medicines, such as aspirin or ibuprofen (Advil, Motrin), and certain vitamins or natural health products can increase the risk of bleeding or interact with anesthesia. You may be asked to stop these medicines before surgery.
• Before the operation, you will speak with a member of the anesthesia team to discuss anesthetic options, including the risks, benefits, and alternatives to each. This may be on the phone, or in person.
• Ask if a special tour of the operating area and hospital is available.

Taking care of your child before surgery

• Build healthy habits into your child's life.
  • Help your child to stay as active as possible.
  • Teach about and support a healthy diet.

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 his or her 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 his or her teeth. Remind your child not to swallow any toothpaste or water.
• Be sure your child has something that reminds him or her 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 an anesthesia provider. 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 he or she is having.
• 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.
• The surgery will take at least several hours. The amount of time that the surgery will take depends on the type of operation needed.
• After the surgery, your child will be taken to the intensive care unit (ICU).
• Before your child wakes up, the doctor will probably talk to you about the surgery. When your child wakes up in the ICU, the nurse will check his or her vital signs (temperature, blood pressure, pulse rate, and breathing) and make sure that your child is comfortable. You will be allowed to see your child soon after surgery.
• Your child may have a breathing tube down his or her throat. This may be removed several hours after surgery, or the doctor may leave it in place for several days.
• Your child may have a thin plastic tube, called a catheter, in a vein in his or her neck. 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 will have chest tubes to drain fluid and blood from his or her 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.
• Your child may have one or more thin wires coming out of his or her 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.

Going home

• Your child will probably be tired when he or she comes home. Encourage rest the first few days, but expect your child to want to be more active as he or she heals and feels better.
• Follow your doctor's instructions about when your child can do intense exercise, such as sports, running, or physical education.
• When you leave the hospital, you will get more information about how to take care of your child at 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, flu, or a cold).
• You need to reschedule or have changed your mind about your child having the surgery.