Atrial Septal Defect Repair in Children—Open Heart Surgery Overview
Call 911 If Any of the Following Occurs
Call 911 or go to the emergency room immediately if any of the following occurs in your child:
- Fast breathing or trouble breathing
- Blue or gray skin color
- Not waking up or not interacting
In case of an emergency, CALL 911.
Call Your Doctor If Any of the Following Occurs
After your child leaves the hospital, call your doctor if any of the following occurs:
- Signs of infection, including fever and chills
- Increased sweating
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
- Incision opens
- Nausea and/or vomiting
- Increased pain
- Problems with urinating (eg, pain, burning, urgency or frequency of urination, blood in the urine) or not urinating
- Cough, shortness of breath, or chest pain
- Rattling in the chest
- Not wanting to eat or drink
- Noisy breathing
An atrial septal defect is a hole in the wall between the two upper chambers (right and left atriums) of the heart. Open heart surgery can repair the hole, either by closing the hole with stitches or by placing a patch over it.
![Patch Repair for Atrial Septal Defect]
: image/65 "Patch Repair for Atrial Septal Defect" center
What to Expect
#Prior to Procedure
The doctor will examine your child. The doctor may order tests, like:
- Blood and urine tests
- Echocardiogram —a test that uses sound waves to visualize heart functioning
- Electrocardiogram (ECG, EKG)—a test that records the heart's activity by measuring electrical currents through the heart muscle
- Chest x-ray —a test that uses radiation to take a picture of structures inside the chest
- Cardiac catheterization —the insertion of a tube-like instrument into the heart through an artery
The doctor will tell you if your child needs to stop taking medicines. Ask the doctor when your child should stop eating or drinking before the surgery.
General anesthesia will be used. It will block pain and keep your child asleep through the surgery.
#Description of the Procedure
First, the doctor will cut through the skin and breastbone. The chest cavity will be opened. Next, the heart will be connected to a heart-lung machine. This machine will take over the functions of the heart and lungs. The doctor will stop the heart to do surgery.
The pericardial sac around the heart will be opened. The doctor may remove a small part of this sac and use it to patch the hole. A cut will be made in the right atrium. A small hole will be closed with sutures. A larger hole will be covered with a patch that is made of the sac or other material. Once the defect is repaired, the doctor will close the incision. The heart will then be restarted. Once it is working fine, the heart-lung machine will not be needed. The doctor will close the chest cavity. Sutures will be used to close the skin.
#Immediately After Procedure
Your child will be monitored in the intensive care unit (ICU) with the help of the following devices:
- Heart monitor
- Breathing tube (until your child can breathe on his own)
- Chest tubes—to drain fluids that have collected in the chest
- A line into an artery in the arm or leg—to measure blood pressure
- A tube through the nose and into the stomach—to drain fluids and gas that collect in the stomach
- Bladder catheter
#How Long Will It Take?
#How Much Will It Hurt?
Pain or soreness during recovery will be managed with pain medicine.
#Average Hospital Stay
The usual length of stay is 5-7 days. If there are complications, your child may need to stay longer.
##At the Hospital
The hospital staff may:
- Do tests (eg, ECG, blood tests).
- Give pain medicine.
- Gradually transition your child to a normal diet.
When your child returns home, do the following:
- If directed by the doctor, give antibiotics. This will help to prevent endocarditis. Also, give pain medicine as needed.
- Keep the incision area clean and dry. Avoid applying lotion or powder to this area.
- Have your child return to his normal diet.
- Do not give your child a bath or allow him to shower for 10 days after surgery.
- Encourage your child to rest, especially during the first few days. He will slowly return to normal activities. Have your child avoid rough play.
- Dress your child in loose, comfortable clothing.
- If your infant had surgery, hold him by supporting his back and buttocks. Do not pull your baby up by the arms or under the arms.
- Follow all of the doctor’s instructions.
In about six months, the heart tissue will grow over the sutures or patch.
American Heart Association
National Library of Medicine
Heart and Stroke Foundation
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. Updated April 2010. Accessed April 21, 2010.
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