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.

CARE AGREEMENT:

You have the right to help plan your child's care. To help with this plan, you must learn about your child's health condition and how it may be treated. You can then discuss treatment options with your child's caregivers. Work with them to decide what care may be used to treat your child.

RISKS:

There are always risks with surgery. Your child may bleed more than usual, get an infection, or have trouble breathing. Blood clots or air bubbles in your childʼs blood could cause a stroke. The heart muscle or valves could be damaged. Your child could have problems with his heartbeat or he could have a heart attack. Caregivers will watch your child closely for these problems and will work to decrease the problems.
Without surgery, your child could get worse. If he is having heart failure symptoms like shortness of breath and fatigue (tiredness), these could get worse. If your child has no symptoms, eventually blood and fluid could build up in your childʼs lungs. Then his heart could begin to fail (wear out). Call your childʼs caregiver if you are worried or have questions about your childʼs surgery, medicine or care.

WHILE YOU ARE HERE:

Before Surgery:

Informed Consent:
- You have the right to understand your childʼs health problem. You should understand what tests, treatments, or procedures may be done to treat your childʼs problem. Your childʼs caregiver should also tell you about the risks and benefits of each treatment.
- You may be asked to sign a consent form. If you are unable to give your consent, someone who has permission can sign this form for your child. A consent form is a legal paper that gives a caregiver permission to do certain tests, treatments, or procedures. This form should tell you exactly what will be done to your child. Your childʼs caregiver should explain what the risks and benefits of each treatment are before you sign the form. Before giving your consent, make sure all your questions have been answered.
Gown: A hospital gown is needed so caregivers can easily check and treat your child. Your childʼs gown should be put on so it opens in the back. Your child may be able to wear regular pajamas or clothes when he feels better.
Heart Monitor: This is a machine used to see how your childʼs heart is handling the illness. 3 or 5 sticky pads are placed on your childʼs chest. Each pad has a wire that is hooked to a TV-type screen or to a small portable box. This screen or box shows a picture of your childʼs heartbeat. Caregivers watch this picture to make sure your childʼs heart is doing well.
IV: An IV is a tiny tube placed in your childʼs vein for giving medicine or liquids. This tube is connected to tubing and a bag of liquid near the bed. Depending on his age, your child may get an IV before or after he has been put to sleep for surgery.
Vital Signs: This may include taking your childʼs temperature, pulse (heartbeats), respirations (breaths), and blood pressure. Your childʼs temperature may be taken in the mouth, ear, armpit, or rectum (rear-end). Caregivers may also listen to your childʼs heart and lungs by using a stethoscope (STETH-uh-skop).
Pre-Op Care: Pre-Op care is the care your child gets right before surgery. Your child may be given medicines right before surgery. One of the medicines may make your child feel sleepy and more relaxed. Your child may also be given antibiotics (an-ti-bi-AH-tiks) to help fight infection. Your child will be taken on a cart or crib to the room where surgery will be done. Your child may have special tubes put in him and equipment attached to him during this time. Caregivers will stay with your child all the time to make sure he is warm, safe, and comfortable.
General Anesthesia (an-iss-THEE-zuh): This medicine puts your child to sleep and makes him comfortable during surgery. It may be given in an IV or as a gas through a facemask. This medicine may also go through a tube placed in your childʼs mouth and throat. A mouth tube is called an endotracheal (end-o-TRA-kee-ull) tube or "ET tube".
NG Tube: This is also called a nasogastric (nay-zo-GAS-trik) tube. An NG tube is put down your childʼs nose and into his stomach. An NG tube keeps air and fluid out of the stomach during surgery. It is usually taken out shortly after surgery.
Foley Catheter (KATH-uh-ter): This is a tube that may be put into your childʼs bladder to drain his urine into a bag. The bladder is an organ where urine is kept. It is usually taken out shortly after the surgery.
Pulse Oximeter (oks-IH-mih-ter): This is a machine that tells caregivers how much oxygen is in your childʼs blood. A cord with a clip or sticky strip is placed on your childʼs foot, toe, hand, finger, or earlobe. Tell a caregiver if the sticky strip or clip comes off of your child. The machine will sound an alarm if the machine cannot read the oxygen level. It will also alarm if your child needs more oxygen. Tell a caregiver if the machine is alarming. Never turn the pulse oximeter off.
Special Tubes: Some tubes may be put into an artery or vein (blood vessel) before, during, or after surgery. These help caregivers watch how your child is doing during or after surgery.
- Arterial (r-TEER-e-ull) Line: This tube is also called an "art line" or an "A-line". It is placed into an artery, usually in the wrist or groin. The groin is the area where your childʼs abdomen (belly) meets his upper leg. The art line is attached to tubing with liquid in it. This liquid helps keep the tubing from getting plugged. The tube may be used for measuring your childʼs blood pressure or for drawing blood.
- CVP Line: A CVP line is also called a central line. It is an IV catheter (KATH-uh-ter) or tube. It is put into a large blood vessel near your childʼs collarbone, in your childʼs neck, or groin. The IV may be used to give medicines or to check your childʼs heart.

During Surgery:

Your child may lie on his back during surgery or may be turned on his side after he goes to sleep. A caregiver will clean his chest with special soap. This soap may make your childʼs skin yellow, but it is cleaned off later. Sheets are put over your child to keep the surgery area clean. An incision (cut) is made down the middle of your childʼs chest. An incision may be made between 2 ribs on the right side of your childʼs chest instead of down the middle.
Your child will then be connected to a heart-lung bypass machine. This machine does the work of your childʼs heart and lungs when his heart is stopped during surgery. An incision will be made in the right atrium and the hole in the septum will be closed with stitches. A patch may be sewn over the hole if needed. The patch may be a piece of heart muscle taken from the outside of your childʼs heart. The patch may also be a piece of man-made material.
The heart-lung machine will be stopped and your childʼs own heart and lungs will start working again. The incision in your childʼs chest will be closed with wire and stitches (thread) or staples.

After Surgery:

Your child is taken to the recovery room or an intensive care unit (ICU). He may be asleep or very drowsy. You may have to wait until your child is settled in by caregivers before you can visit your child. Your child may have many tubes in him and equipment attached to him. This is normal after heart surgery. The tubes and equipment may be removed once caregivers feel your child is doing well enough after surgery. Caregivers will watch your child very closely.
A bandage is used to cover your childʼs stitches or staples. This bandage keeps the area clean and dry to prevent infection (in-FECK-shun). A caregiver may remove the dressing shortly after surgery to check the incision. Do not let your child get out of bed until your childʼs caregiver says it is OK. Your family may be allowed to visit your child in the ICU for a short visit several times a day. Check with caregivers to find out what the visiting hours are in your childʼs ICU. Caregivers may move your child out of the ICU and into a regular hospital room once he is well enough after surgery.

Chest Tubes These are tubes that may be put into your childʼs chest during surgery. Chest tubes remove air, blood, or fluid from around the lungs. Then your childʼs lungs can fill back up with air when breathing. The chest tubes are attached to a container with bubbling water. After the chest tubes are removed, your childʼs lungs should be normal.

Using oxygen and a ventilator (VEN-tih-la-ter): Your child may may need extra oxygen when waking up after surgery. A ventilator (breathing machine) helps your child breathe during and after surgery. The ventilator has a tube that connects to your childʼs ET tube. Your child may need extra oxygen after the ET tube has been removed. Your child may need a nasal cannula (small tubes placed in the nose) or mask. Many children do not like having these on their face. So, a caregiver may place an oxygen mask next to your childʼs face. Some children are placed in an oxygen tent or plastic hood. A caregiver will decide which oxygen device is needed for your child. Do not take off your childʼs oxygen without asking your childʼs caregiver first.

Deep Breathing and Coughing: This breathing exercise helps to keep your child from getting a lung infection after surgery. This exercise is done after your childʼs ET tube is out. Deep breathing opens the tubes going to your childʼs lungs. Coughing helps to bring up sputum (spit) from your lungs for your child to spit out. Your child should deep breathe and cough every hour while he is awake. He should even do this if he wakes up during the night.

Your child should hold a pillow tightly against his incision (cuts) when he coughs. This may help decrease some pain. Your child should take a deep breath and hold the breath as long as he can. Then your child should push the air out of his lungs with a deep strong cough. Your child can put any sputum that he coughed up into a tissue. Your childʼs caregiver will tell you how many times and how often your child should do deep breathing and coughing. Help your child remember to follow each deep breath with a cough.
Your child may be asked to use an incentive (in-SEN-tiv) spirometer (sper-OM-ih-ter). This helps him take deeper breaths. Your child should put the plastic piece into his mouth and take a very deep breath. Your child should hold his breath as long as he can. Then he will let out his breath. Your childʼs caregiver will tell you how many times and how often he should use his incentive spirometer.

Eating:

Your child may be able to eat when bowel sounds (stomach growling) are heard. A caregiver will listen for bowel sounds by putting a stethoscope (STETH-uh-skop) on your childʼs belly. A caregiver will then let you know if your child can eat.
Ice chips are usually given first. Then liquids like water, broth, apple juice, or clear soda are given. If your child does not have problems after drinking liquids, a caregiver may let your child eat soft foods. Some examples of soft foods are ice cream, applesauce, or pudding. If your child can eat soft food without problems, he may begin eating a regular diet.

Emotional Support: You may stay with your child for comfort and support. Ask a caregiver if you or another family member can stay with your child. Bring in something from home that your child likes. This may include a blanket, a favorite toy, or clothing. Things from home (like a blanket) that your child knows may help comfort him.

Intake and output (I&O):

Your childʼs caregiver may need to know how much liquid your child is getting and urinating. Caregivers may also want to know how much your child eats and if he had a bowel movement (BM).
You may need to save your childʼs diapers so a caregiver can weigh them. Your child may need to urinate into a container in bed or in the toilet. A caregiver will then measure the amount of urine. Do not throw away diapers or flush urine down the toilet before asking your childʼs caregiver.

Medicines:

Antibiotics (an-ti-bi-AH-tiks): This medicine may be given to help your child fight an infection caused by a germ called bacteria (bak-TEER-e-uh). Some people are allergic (uh-LER-jik) to antibiotics. Tell a caregiver if your child is allergic to antibiotics.
Anti-Nausea Medicine: This medicine may be given to calm your childʼs stomach and control vomiting (throwing up). Your child may have an upset stomach after surgery or taking pain medication.
Diuretics (di-u-REH-tiks): This medicine is often called "water pills." Diuretics help get rid of extra fluid your childʼs body or lungs may have collected. Diuretics may make your child urinate more often.
Fever Medicine: Sometimes children react to the stress of surgery by getting a fever. If your child has a fever that lasts more than a few days, caregivers may run tests to find out why your child has the fever. Otherwise, the fever should go away on its own. Fever medicine is given to help lower a fever. Some examples are acetaminophen (uh-c-tuh-MIN-o-fin) and ibuprofen (i-bew-PRO-fin). Bringing down the fever should help your child feel better. Talk to a caregiver before using these medicines together for your childʼs fever.
Heart Medicine: This medicine may be given to make your childʼs heart beat stronger or more regularly. There are many different kinds of heart medicines. Talk with caregivers to find out what your childʼs medicine is and why he is taking it.
Pain Medicine: Caregivers may give medicine to help your childʼs pain go away. Tell a caregiver if your childʼs pain does not go away or comes back after taking this medicine. Pain medicine can have some side effects. Tell a caregiver if your child has trouble breathing, is very sleepy, or has an upset stomach. Tell a caregiver if you know your child is allergic to pain medicine.

Tests: One or more of the following tests may be done to help caregivers know how your child is doing after surgery:

Blood Gases: Blood is usually taken from an artery or vein (blood vessel) in your childʼs wrist, arm, foot, or groin. The groin is the area where the legs meet the belly. A caregiver may try getting the blood from an artery first. Your childʼs blood is tested for the amount of oxygen, acids, and carbon dioxide (di-OKS-ide). Blood gases are usually done if your child has trouble breathing or other problems caused by his illness.
Blood Tests: Your child many need blood taken for tests. The blood may be taken from your childʼs arm, hand, finger, foot, heel, or IV. It is tested to see how your childʼs body is doing after the ASD surgery. Your child may need to have blood drawn more than once.
Chest X-ray: This is a picture of your childʼs lungs and heart. Caregivers use it to see how your childʼs lungs and heart are doing after the ASD surgery. The chest x-ray can show problems such as pneumonia (new-MOAN-yuh). it may also show a collapsed lung, or if your childʼs heart is too large.
Echo: This test is also called an echocardiogram (eh-ko-KAR-d-o-gram). Sound waves are used to show pictures of the size and shape of your childʼs heart. The pictures are shown on a TV-like screen. The echo and color flow Doppler can show how well the heart is pumping and how well blood flows through it after the ASD surgery.

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.

Link to Page

Print Page

Email Page

	Search:
Browse all medications A B C D E F G H I J K L M N O P Q R S T U V W X Y Z	Advanced Search