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.
GETTING READY:
The Week Before Surgery:
- Tell your childʼs caregiver about any medicines your child is taking. Ask your childʼs caregiver about any medications your child should or should not take before the surgery.
- Your child may need blood tests before the procedure. Talk to your child’s caregiver about these or other tests he may need. Write down the date, time and location for each test.
- You and your child may be given a tour of the intensive care unit (ICU) before your childʼs surgery. This will let your child see where he will go after surgery. Talk to your child about the surgery so that he can know what to expect and be less afraid. Ask caregivers to help you explain and prepare your child for surgery.
- Your child will usually not need a blood transfusion during surgery. However, your child may be able to donate blood before surgery in case he needs it. This is called autologous (ah-TALL-uh-gus) blood donation. This must be done no later than 3 days before surgery. You may also ask a family member or friend with the same blood type to donate their blood. This is called directed blood donation. Talk to a caregiver for more information on autologous or directed blood donation.
- Informed consent: You have the right to understand your child's health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your child's condition. Your child's caregiver should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives your child's caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to your child. Before giving your consent, make sure all your questions have been answered so that you understand what may happen to your child.
The Night Before Surgery:
- Your child should get a good night sleep the night before surgery.
- Ask caregivers about directions for eating and drinking.
The Day of Surgery:
- Write down the correct date, time, and location of your surgery.
- Ask your childʼs caregiver before giving your child any medicine the day of surgery. Bring a list of your childʼs medicines or the pill bottles with you to the hospital.
- If your child is staying in the hospital after surgery, bring some of your childʼs things with you. These may include pajamas, toothbrush, hairbrush, slippers, special blanket or toy.
- Your childʼs caregiver will tell you what your child can and cannot wear the day of the surgery.
- An anesthesiologist (an-iss-thee-z-ALL-o-jist) may talk to you before your childʼs surgery. This is the caregiver who gives the medicine to make your child sleepy during surgery.
TREATMENT:
What Will Happen:
- Medicine to help your child relax or make him drowsy may be given before surgery. A caregiver will take your child to the operating room on a wheeled cart or in a crib. Your child will be given general anesthesia (an-iss-THEE-zuh) to keep him completely asleep during surgery.
- A caregiver will clean your childʼs chest with a special soap. An incision (cut) will be made down the middle of your childʼs chest. It may also be made between 2 ribs on the right side of your childʼs chest instead of down the middle. Your child will 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 the heart. The patch may 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 will be taken to the recovery room or an intensive care unit (ICU). He may be asleep or very tired. Your child may have many tubes in him and equipment attached to him. These will be removed once caregivers feel he is doing well enough after surgery. You may have to wait until your child is settled into his bed before you can visit him. Caregivers will watch your child very closely.
- A bandage will be 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. Check with caregivers to find out what the visiting hours are in your childʼs ICU. Your child may move out of the ICU and into a regular hospital room once he is well enough after surgery.
Waiting Room: This room is where you and your family can wait during surgery until your child can have visitors. You may also wait here after your childʼs surgery. Your childʼs caregiver can then find you to let you know how the surgery went. Before the surgery, your childʼs doctor will tell you how long the operation will take. Sometimes a surgery may last longer than the doctor says. If you or your family leave the hospital, leave a phone number where you can be reached.
CONTACT A CAREGIVER IF:
- You cannot get your child to his surgery appointment on time.
- Your child has a fever (increased body temperature).
- Your child accidentally ate or drank something after they should not have. The surgery may need to be done later because of this.
- The problems for which your child is having surgery get worse.
- You have questions or concerns about your childʼs surgery.
Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.
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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