Pediatric and Congenital Heart Surgery - Patient Care and Treatment
Pediatric and Congenital Heart Surgery - Patient Care and Treatment
What to expect
If your child has congenital (present at birth) heart disease, your doctor may refer him or her to a specialist called a pediatric cardiologist.
To find out if surgery is needed, your child’s cardiologist will perform a complete physical exam that focuses on the cardiovascular system (heart and blood vessels).
Your child will probably need some tests that help the doctor learn more. Tests may include:
- Electrocardiogram (ECG) – electrodes placed on the chest measure the heart’s electrical activity. Creates a record of your child’s heartbeat.
- Echocardiogram – uses ultrasound waves to create a picture of your child’s heart.
- CT scan – uses X-rays and computer technology to create a picture of your child’s heart.
- MRI scan – uses a large magnet and radio waves to create a picture of your child’s heart.
- Cardiac catheterization – a long thin tube called a catheter is inserted into a large blood vessel that leads to the heart. It’s usually inserted from the groin or arm. The doctor can then take a blood sample, measure pressure and oxygen, or perform other activities to learn about the condition of your child’s heart.
Preparing for surgery
After we have the results of these tests, our team will review the information at a weekly conference. This is where our entire group of pediatric cardiologists and pediatric cardiac surgeons work together to determine the best surgical treatment for your child.
Your child will also be evaluated by our pediatric cardiac anesthesiologists. Anesthesiologists are specialists who help your child remain comfortable and pain-free during surgery.
We encourage you to take a tour of our facility to see what’s here and learn your way around. This will help you and your child to feel more at ease on the day of surgery.
A few days before surgery, a cardiology nurse will call you to answer any questions you might have. He or she will also talk to you about:
- What time to arrive at the hospital on the day of surgery
- Eating and drinking instructions for your child (no eating or drinking before surgery)
- Medication instructions for your child
Day of surgery instructions
- Most patients who need open heart surgery are admitted to the hospital the morning of surgery.
- Please report to the Penn State Children's Heart Group, Pediatric Cardiac Surgery Office. This is located on the fifth floor of the Children's Hospital at 600 University Drive, Hershey.
- You may park in the patient parking lot or garage located behind the Penn State Medical Center. Parking is free.
- Your child must not eat or drink before surgery. If your child has anything to eat or drink, the surgery may be delayed or rescheduled.
- It is very important that a family member be available during and after the surgery.
- Family members may wait on the 4th floor family waiting room outside the Pediatric Intensive Care Unit.
- If you wish to leave the hospital during the surgery, a receptionist at the waiting room desk will give you a pager.
- A nurse will keep you informed about your child's progress and condition throughout surgery. The doctor will speak with you after surgery.
- Please call our office at 717-531-8674 or 717-531-2050 if you have any questions about the instructions.
After surgery, your child will be cared for in the Pediatric Cardiac Care Unit. Parents may visit 24 hours a day. You can sleep in the room at your child’s bedside.
Most patients are able to leave the hospital within several days. We will only keep your child here as long as necessary for medical care. We believe that recovery occurs best at home with parents and family.
After surgery care
- Any stitches will be removed before your child goes home.
- Some children will have small pieces of tape (steri-strips) covering the top layer of skin. Ten to 14 days after surgery the steri-strips will begin to dry up and peel off. Allow the steri-strips to fall off on their own.
- Some children have small incisions from the chest tubes. It is normal to have a small amount of clear yellow or dark bloody drainage from this incision. You can use a dry Band-Aid or light gauze if there is drainage.
- Your child may bathe or shower the day after the stitches are removed. It is best not to let your child soak in the tub until the incision is completely healed. This usually takes about seven to 10 days.
- Do not put lotion, oil or cream on the incision until it is completely healed.
- The incision will fade best if your child stays out of the sun for several months after surgery. Use sunscreen (at least SPF 15).
- Allow your child to play at his or her own pace.
- Avoid activities that may cause injury to the chest, such as contact sports, physical education (gym class), sledding, bike riding, playing on swings and slides, or roughhousing.
- Avoid activities that require vigorous use of the arms for about six weeks after surgery. Examples of activities to avoid include crawling, shoveling, lawn mowing, golfing, tennis, bowling, swimming, push-ups/chin-ups.
- Your child may not lift anything over 5 pounds until six weeks after surgery.
- Do not lift your child under the arms. Instead, lift your child by supporting his bottom and back. Lifting under the arms can stretch the incision and cause pain.
- Most children can return to school about two weeks after their clinic visit.
- For older kids, do not allow your child to drive for four weeks. If your car does not have automatic transmission and power steering, your child should wait six weeks to start driving.
- Most children only experience mild discomfort by the time they go home.
- Chest pain is not unusual. Gas pains may seem to be "chest pain" to a child. To relieve chest pain, try walking or rocking.
- Give Tylenol (acetaminophen) at the age-appropriate dose and frequency.
- Your child may have trouble sleeping after leaving the hospital.
- Appetite loss for two to three weeks after heart surgery is common.
- Encourage your child to eat and drink. Your child may prefer cold foods over hot.
- Protect your child from colds and illnesses by avoiding day care and crowded areas.
- Your child will need to take antibiotics to help prevent bacterial endocarditis (infection of the heart lining or valves) after heart surgery,.
- Your child will need to continue to take antibiotics before having dental work or certain surgical procedures.
- A few children will be able to stop taking antibiotics six months after surgery. Be sure to discuss this with your child's pediatric cardiologist.
Problems to look for
- Cloudy yellow drainage from the incision
- Increased redness or swelling (bulging) of the incision
- Fever over 101.5° F by mouth (100.5° F under the arm for infants and young children)
- Persistent vomiting
- Increased pain
- Shortness of breath, breathing difficulties
- Breastbone popping or clicking