Some childhood heart defects require repairs that can only be made through open-heart surgery. These repairs may be needed right away, or they may be delayed for months or even years. Sometimes repairs can be made in a single surgical procedure. Other times, a series of operations may be needed. It all depends on the type and severity of the heart defect and how sick the child is.
If surgery is required, the child’s medical team includes specialists with the training needed to care for children. The team may include a pediatric heart surgeon, a pediatric anesthesiologist, pediatric heart-lung pump technologists, pediatric surgical nurses and technicians and pediatric intensive care physicians and nurses.
During surgery, the child is placed under general anesthesia. Depending on the repair to be made, the surgeon may make an incision through the breastbone (sternum) and between the lungs, or on the side of the chest between the ribs.
During surgery, it is sometimes necessary to stop the heart in order to perform the repairs. If stopping the heart is necessary, the child is placed on a heart-lung bypass machine, which takes over the work of the heart. It adds oxygen to the blood and keeps it circulating through the body during the surgery.
Depending on the complexity of the procedure, heart surgery for a child may take up to 12 hours in the operating room.
After surgery, the child is moved to the intensive care unit (ICU), where he or she will stay for several days of monitoring and treatment. During this time, the child will have tubes to help with breathing; deliver fluids or medications directly into the veins; measure blood pressure; drain air, blood and fluid from the chest cavity; empty the stomach; provide medicine and/or food; and drain the bladder.
Possible Complications with Surgery and Hybrid Procedures for Congenital Heart Disease
Minor and major complications can result from open-heart surgery. Minor complications can include:
- Nausea and vomiting
- Minor infections
- Minor bleeding or bruising
- Abnormal or painful scar formation
- Allergic skin reaction to tape, dressings or latex
- Skin numbness
Among the rare but more serious complications that can occur are stroke, heart attack and other heart and lung problems, serious bleeding, kidney failure, nerve or organ damage and allergic reaction to medications.