Consumer Information

Atrial Septal Defect Surgical Repair In Children

WHAT YOU SHOULD KNOW:

Atrial (A-tree-ull) septal (SEP-tull) defect surgery is done to close a hole in a wall inside the heart. ASD is a common heart defect that babies are born with. The heart has 4 chambers or rooms called the atria (A-tree-uh) and the ventricles (VEN-trik-ulls). With an ASD, there is a hole in the septum (wall) between the 2 upper chambers, the right and left atria. An ASD causes blood to flow through the heart in a different way. Your childʼs heart and lungs must work harder because of this.
Tests will be done to learn more about your childʼs heart and the ASD. Most people with an ASD need to have the hole closed even if they have no symptoms. An ASD in a child can often be sewn closed with stitches (thread). It may also be patched with heart tissue or special cloth-like material sewn in place to close the hole.

AFTER YOU LEAVE:

Medicines:

Keep a written list of the medicines your child takes and when and why your child takes them. Bring the list of your childʼs medicines or the pill bottles when you visit your childʼs caregivers. Ask your childʼs caregiver for more information about the medicines. Do not give any medicines to your child before asking your childʼs caregiver. This includes prescriptions, over-the-counter drugs, vitamins, herbs, or food supplements.
Always give your childʼs medicine as directed by caregivers. Call your childʼs caregiver if you think your childʼs medicines are not helping. Call your childʼs caregiver if you feel your child is having side effects. Do not quit giving the medicines to your child until you ask your childʼs caregiver.
If your child is taking antibiotics (an-ti-bi-AH-tiks), give them until they are all gone. Even if your child seems to feel better.
Do not give aspirin to your child without first asking your childʼs caregiver. Giving aspirin to your child when he is ill may cause a very serious illness called Reyeʼs syndrome. Read medicine labels to see if your childʼs medicine has aspirin.

Appointment:

Ask your child's caregiver when to return for a follow-up visit. Keep all appointments. Write down any questions you and your child may have. This way you will remember to ask these questions during your child's next visit.

Activity:

Children usually get better quickly after surgery. Resting helps your childʼs body heal itself. Encourage your child to rest as much as needed. If your child does not nap, have him take a quiet time each day. Talk to your childʼs caregiver if you have any questions.
If your childʼs chest bone was opened during surgery (sternotomy), he may have activity limits for 1 month or more. Your child may not be able to ride bicycles and tricycles, climb on playground equipment, or play contact sports. Your childʼs caregiver will tell you when your child can return to regular activities.

Bathing with Stitches: When your child is allowed to bathe, carefully wash the stitches or staples with soap and water. Afterwards put on a clean, new bandage. You should change your childʼs bandage any time it gets wet or dirty.

Colds or the Flu: Keep your child away from people who have colds, flu, or other illnesses that are easily spread. Also try to keep your child away from large groups of people while he is recovering from surgery. This decreases your childʼs chance of getting sick or getting an infection.

Dental visits:

Your child may not be able to go to the dentist until 4 to 6 weeks after surgery. Your child may need to take antibiotics if he goes to the dentist within 6 months after surgery. Ask your childʼs caregiver how soon your child can go to the dentist after surgery. Antibiotics before dental work may protect your child from getting a heart infection called bacterial (bak-TEER-e-ull) endocarditis (end-o-kar-DI-tis). Tell your childʼs dentist about your childʼs ASD and surgery.
Keep your childʼs gums and teeth healthy by having your child use dental floss and brush with fluoride toothpaste twice each day. Gently rub the teeth and gums of your infant with water and gauze or soft cloth to keep them clean and healthy.

Returning to school or daycare: Your childʼs caregiver will tell you when your child can return to school or daycare. If there are special instructions for your child, ask your childʼs caregiver to write a note to the school. Talk to your childʼs teachers or school nurse about your childʼs ASD and surgery.

Support:

Many children stop having heart problems after their ASD is closed. Heart problems can be life-changing for you, your child, and your family. Accepting that your child has or did have heart problems is hard. You may feel angry, sad, or frightened. These feelings are normal. Talk to your childʼs caregivers, your family or friends about your feelings. Let them help you. Encourage those close to you to talk to your childʼs caregiver about how things are at home. Your childʼs caregiver can help your family better understand how to support a child who has heart surgery.
You may also want to join a support group. This is a group of people who have children with heart problems. Ask your childʼs caregiver for the names and numbers of support groups in your town. You can contact the following national organization for more information.
- American Heart Association National Center
  7272 Greenville Avenue
  Dallas, TX 75231-4596
  Phone: 1-800-242-8721
  Web Address: http://www.americanheart.org

Wellness Hints:

Diet: Feed your child healthy food from all of the 5 food groups: fruits, vegetables, breads, dairy products, meats and fish. If your child is an infant, feed him formula and other foods as directed by his caregiver. Eating healthy foods may help your child feel better and have more energy. It may also help your child get better faster.
Liquids: Give your child 6 to 8 (soda pop can size) glasses of liquid each day. Follow the advice of your childʼs caregiver if you must limit the amount of liquid your child drinks. Good liquids for your child to drink are water, juices, and milk. Limit the amount of caffeine your child drinks, such as coffee, tea, soda pop, and certain sports drinks.
Second-hand smoke: Do not let anyone smoke around your child. Smoke can make your childʼs coughing or breathing worse. If you smoke, you should quit. Smoking can harm your and your childʼs heart, lungs, and blood. Your child is more likely to get lung disease and cancer if you smoke around him. It is never too late to quit. If you are having trouble quitting, talk to your caregiver about ways to quit.

CONTACT A CAREGIVER IF:

Your child has pain that will not go away.
Your childʼs stitches or staples come apart.
Your child shows signs that he is getting an infection:
- The skin around your childʼs stitches is red or swollen.
- There is pus or bad-smelling fluid coming from the incision (cut).
- Your child has a fever (increased body temperature).
- Your child has a cough or sounds congested (stuffed-up).
Your child vomits more than 2 times in 1 day.
Your childʼs skin is itchy, swollen, or has a rash. The medicine your child is taking may be causing these symptoms. This may mean your child is allergic (uh-LER-jik) to a medicine he is taking.
You have any questions or concerns about your childʼs surgery, medicine or care.

SEEK CARE IMMEDIATELY IF:

Your childʼs incision (cut) starts bleeding a lot suddenly and will not stop.
Your child has trouble breathing all of a sudden. This could be a sign that your child has a blood clot in his lung. It could also mean that your child is allergic to a medicine he is taking. Call 911 or 0 (operator) for an ambulance to get to the nearest hospital or clinic. Do not drive your child to the hospital yourself!

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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