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Atrial Septal Defect Repair in Children
WHAT YOU NEED TO KNOW:
An atrial septal defect repair (ASD) repair is surgery to close a hole in the septum (wall) between the upper chambers of your child's heart. The upper chambers are called the right atrium and the left atrium. An ASD repair is done through open heart surgery.
Call 911 for any of the following:
- Your child has severe chest pain.
- Your child has trouble breathing or sudden shortness of breath.
- Your child coughs up blood.
- Your child loses consciousness or stops breathing.
- Your child has any of the following signs of a stroke:
- Part of his face droops or is numb
- Weakness in an arm or leg
- Confusion or difficulty speaking
- Dizziness, a severe headache, or vision loss
Seek care immediately if:
- Blood soaks through your child's bandage.
- Your child's stitches come apart.
- Your child's heart is beating faster or slower than usual.
- Your child's mouth, lips, or tongue is blue.
- Your child is restless or anxious.
- Your child has swelling in his legs or feet.
- Your child has severe abdominal pain or his abdomen is larger than usual.
- Your child stops urinating or urinates less than usual.
Contact your child's healthcare provider if:
- Your child has a fever or chills.
- Your child's pain does not get better after he takes medicine.
- Your child's appetite is poor.
- Your child gets tired easily when he is eating.
- Your child's wound is red, swollen, or draining pus.
- Your child has nausea or is vomiting.
- Your child's skin is itchy, swollen, or he has a rash.
- Your child does not gain weight, or he loses weight.
- You have questions or concerns about your child's condition or care.
Your child may need any of the following:
- Heart medicine may be given to control your child's heartbeat or strengthen his heart.
- Diuretics may be given to remove extra fluid.
- Antibiotics may be given to prevent a bacterial infection.
- Prescription pain medicine may be given. Ask your child's healthcare provider how to give him this medicine safely.
- Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much to give your child and how often to give it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.
- NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. NSAIDs can cause stomach bleeding or kidney problems in certain people. If your child takes blood thinner medicine, always ask if NSAIDs are safe for him or her. Always read the medicine label and follow directions. Do not give these medicines to children under 6 months of age without direction from your child's healthcare provider.
- Do not give aspirin to children under 18 years of age. Your child could develop Reye syndrome if he takes aspirin. Reye syndrome can cause life-threatening brain and liver damage. Check your child's medicine labels for aspirin, salicylates, or oil of wintergreen.
- Give your child's medicine as directed. Contact your child's healthcare provider if you think the medicine is not working as expected. Tell him or her if your child is allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs your child takes. Include the amounts, and when, how, and why they are taken. Bring the list or the medicines in their containers to follow-up visits. Carry your child's medicine list with you in case of an emergency.
Care for your child's wound as directed:
- Ask your child's healthcare provider when you can remove his bandage and bathe him. Your child may only be able to take a sponge bath or shower. A bath may increase his risk for a wound infection. Carefully wash around the wound with soap and water. It is okay to let soap and water gently run over the incision. Do not scrub your child's incision. Gently pat the area dry.
- Replace his bandage after bathing as directed. Change his bandages when they get wet or dirty. Do not put powders or lotions on your child's incision unless his healthcare provider says it is okay. Do not let him swim until his healthcare provider says it is okay. This will decrease his risk for a wound infection. Check his incision every day for signs of infection, such as redness, swelling, or pus.
Prevent infection in your child:
- Wash your hands and your child's hands often. Use a germ-killing hand gel if soap and water are not available. Wash your hands often. Use soap and water. Wash your hands after you use the bathroom, change a child's diapers, or sneeze. Wash your hands before you prepare or eat food.
- Keep your child away from people who are sick. Ask family or friends not to visit if they are sick. Ask all visitors to wash their hands. Do not take your child to crowded places such as the mall or movies. Ask his healthcare provider how long you need to follow these directions.
- Ask your child's healthcare provider if he needs antibiotics before procedures. Some procedures can cause bacteria to get into your child's blood. The bacteria can travel to his heart and damage his heart. Your child may need antibiotics before certain procedures that happen in the next 6 months to prevent this. This may also include certain dental procedures. Ask your child's healthcare provider for more information.
- Ask your child's healthcare provider about vaccines. Your child may need to wait 2 to 3 months before he can get vaccines. He should continue with his vaccine schedule after this. He should get a flu vaccine every year.
Care for your child:
- Limit your child's activity as directed. Do not let your child lift anything heavy or play sports. These actions can put stress on his incision and cause it to come apart. Ask his healthcare provider what activities are safe for him to do. Also ask when he can return to his normal activities and to school or daycare.
- Handle your child carefully. Do not pick your child up by his arms. This may place too much stress on his incision and cause pain. Place pillows behind his back and head when you hold or feed him.
- Have your child drink liquids as directed. This may prevent blood clots and help your child heal faster. Ask how much liquid your child should drink each day and which liquids are best for him. If your child still breastfeeds, ask how much he should drink each day. You may need to feed your child smaller amounts more often until he is stronger.
- Feed your older child heart healthy foods. Examples include fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish. Ask if your child needs to be on a special diet. You may need to limit the amount of salt your child has each day. Too much salt may cause fluid to buildup in his body and put stress on his heart.
Follow up with your child's healthcare provider as directed:
Your child will need to return for tests. These tests will make sure his heart is working correctly. Write down your questions so you remember to ask them during your visits.
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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.
Learn more about Atrial Septal Defect Repair in Children (Discharge Care)
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