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Congenital heart defect corrective surgery

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Illustrations

Heart, section through the middle
Heart, section through the middle
Cardiac catheterization
Cardiac catheterization
Heart, front view
Heart, front view
Ultrasound, normal fetus - heartbeat
Ultrasound, normal fetus - heartbeat
Ultrasound, normal fetus - heartbeat
Ultrasound, normal fetus - heartbeat
Patent ductus arteriosis (PDA) - series
Patent ductus arteriosis (PDA) - series

Alternative names    Return to top

Patent ductus arteriosus ligation; Hypoplastic left heart repair; Tetralogy of Fallot repair; Coarctation of the aorta repair; Heart surgery for children; Atrial septal defect repair; Ventricular septal defect repair; Truncus arteriosus repair; Total anomalous pulmonary artery correction; Transposition of great vessels repair; Tricuspid atresia repair; VSD repair; ASD repair; PDA ligation

Definition    Return to top

Surgery to correct or treat birth defects of the heart (congenital heart disease) is required if the defects threaten the child's well-being or life.

Description    Return to top

Heart defects come in all types, from minor to major. Defects can occur inside the heart or in the large blood vessels outside the heart. The heart defect may need immediate surgery or may be able to safely wait for months or years. In most cases, the timing of the surgery will depend on how sick the baby is.

The heart defect may be repaired in a single surgical procedure or may require a series of procedures. Surgery may involve opening the heart to repair defects or repairing defects of the blood vessels.

An incision may be made through the breastbone (sternum) and between the lungs (mediastinum) while the child is under general anesthesia. For some heart defect repairs, the incision is made on the side of the chest, between the ribs (thoracotomy) instead of through the breastbone (sternotomy).

It is sometimes necessary to use tubes to re-route the blood through a special pump (heart-lung bypass machine) that adds oxygen to the blood and keeps it warm and moving through the rest of the body while the repair is being done. This machine does the work of the heart and lungs during the operation.

Heart surgery for children requires a specialized team of health care providers:

Heart surgery requires intensive and extensive monitoring, treatment and coordination by the entire team. Heart surgery for children may take as many as 12 hours in the operating room.

After heart surgery, the child will be moved to the intensive care unit (ICU) to be constantly and closely monitored and treated for several days. During this time the child will have the following:

The child may also have pacemaker wires in the chest in case a pacemaker is needed to regulate heartbeat and rhythm.

SPECIFIC HEART DEFECT SURGERIES INCLUDE:

Patent ductus arteriosus (PDA) ligation

Coarctation of the aorta repair

Atrial septal defect (ASD) repair

Ventricular septal defect (VSD) repair

Tetralogy of Fallot repair

Transposition of the great vessels repair

Truncus arteriosus repair

Tricuspid atresia repair

Total anomalous pulmonary venous return (TAPVR) correction

Hypoplastic left heart repair

Indications    Return to top

The type and timing of surgical repair depends on the child's condition and the type and severity of heart defects.

In general, symptoms that indicate that surgery is needed include the following:

Risks    Return to top

Risks for any anesthesia include the following: Risks for any surgery include the following: Additional risks of heart surgery include the following:

Expectations after surgery    Return to top

The outcome of heart surgery depends on the child's condition, the type of defect, and the type of surgery. Many children recover completely and lead normal, active lives.

Convalescence    Return to top

Most children need to stay in the intensive care unit (ICU) for 3 to 7 days and then stay in the hospital for 5 to 14 days. By the time the child is transferred out of the ICU, most of the tubes and wires have been removed and the child is encouraged to resume many of his daily activities.

At the time of discharge, parents are instructed on activity, how to care for the incision, and how to give medications their child may need.

The child needs at least several more weeks at home to recover.

Update Date: 4/13/2004

Updated by: John A. Daller, M.D., Ph.D., Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas. Review provided by VeriMed Healthcare Network.

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