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Atrial Septal Defect Repair in Children
WHAT YOU NEED TO KNOW:
What do I need to know about an atrial septal defect (ASD) repair?
An 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.
What else do I need to know about an ASD repair?
- Your child will stay in the hospital for a few days after surgery. He may spend the first 1 to 2 nights in the intensive care unit (ICU). He may have several drains and IVs, and be on a ventilator. A ventilator is a machine that gives your child oxygen and breathes for him when he cannot breathe well on his own. An endotracheal (ET) tube is put into his mouth or nose and attached to the ventilator. The ET tube may be removed when your child is awake and breathing well. Your child may need a blood transfusion to replace blood that he lost during surgery.
- Your child's face and body may look swollen right after surgery. The swelling should go down in a few days. Your child may have pain where the incision was made. He will get medicine to control pain and make him comfortable. It is normal for him to be tired at first, and get stronger each day. He may need several weeks to recover from surgery.
- It may be difficult for you and your family to go through this surgery with your child. You may want to bring someone to the hospital who can support you during this time. You can also talk about any concerns with members of your child's care team.
What do I need to do to prepare my child for an ASD repair?
- Your child's surgeon will talk to you about how to prepare your child for surgery. Ask when and how to talk to your child about surgery. If your child is old enough, talk to him and let him know what to expect. Listen to his fears. Tell him it is okay to be scared. Explain that healthcare providers will make sure he is comfortable. They will make sure he does not feel any pain and stays asleep until the procedure is over.
- Ask if there is information that explains anesthesia and the surgery to you and your child in more detail. Information given in a video or books may be available. Your healthcare provider may be able to take you and your child on a tour of the procedure room. Let your child pick out a favorite blanket, stuffed animal, or toy to take with him to the hospital.
- Your child may need blood tests, a chest x-ray, an EKG, or an echocardiogram before his surgery. He may need to stay in the hospital the night before his surgery to complete these tests. The tests will help his surgeon plan for his surgery. They will also make sure your child is ready for surgery. Your child may be able to donate his own blood before surgery. You, a family member, or a friend with the same blood type as your child, may be able to donate blood for him.
- Your child's surgeon may tell you not to give your child anything to eat or drink after midnight on the day of his surgery. He will tell you what medicines to give him or not give him on the day of his surgery. Your child will be given an antibiotic through his IV on the day of surgery. This will help prevent a bacterial infection. Tell the healthcare provider if he has ever had an allergic reaction to an antibiotic. He may also be given IV medicine to help him stay calm. Your child's healthcare provider may let you be with your child until he is asleep.
What will happen during an ASD repair?
- Your child will be given general anesthesia to keep him asleep and free from pain during surgery. An IV may be placed in your child's wrist to monitor his blood pressure. A second IV may be placed in a large vein to monitor pressures in his heart. Your child's surgeon will make an incision in his chest. He will cut or spread your child's ribcage apart to reach his heart. Your child's heart may be connected to a bypass machine. This machine will pump blood to his body and keep blood out of his heart during surgery.
- Your child's surgeon will make a second incision in your child's heart. He will close the ASD with stitches or a patch. The bypass machine will be stopped and blood will flow through your child's heart again. The incision in your child's heart will be closed with stitches. His surgeon may place a drain in his chest to remove air, blood, or fluid. The incision in your child's chest will be closed with wire and stitches or staples. A bandage will be placed over the incision.
What will happen after an ASD repair?
Healthcare providers will monitor his blood pressure, heartbeat, oxygen levels, and breathing. They will check your child's bandage for bleeding or swelling. Do not let your child get out of bed until healthcare providers say it is okay. He may need blood tests, chest x-rays, an EKG, or an echocardiogram before he leaves the hospital. These tests will make sure the ASD is closed and your child's heart is working correctly.
What can I do to help my child recover in the hospital after surgery?
- Do not give your child anything to eat until his healthcare provider says it is okay. He may be given ice chips at first. Then he can have liquids such as water, broth, juice, and clear soft drinks. If his stomach does not get upset, he may be given soft foods, such as ice cream and applesauce. Once he can eat soft foods easily, he may slowly begin to eat solid foods.
- Help your child cough and deep breathe. This will decrease his risk for a lung infection. Have your child take deep breaths and cough 10 times each hour. Your child should hold a pillow tightly against his incision when he coughs. Tell him to take a deep breath and hold it for as long as he can. Then tell him to let the air out and cough strongly.
- Help your child get out of bed when healthcare providers say it is okay. Help your child get out of bed to sit in a chair or take short walks. These activities will help prevent him from getting a blood clot.
What are the risks of an ASD repair?
Your child may bleed more than expected or get an infection. He may get a blood clot in his leg, arm, heart, lungs, or brain. Fluid may buildup around his heart or lungs and make it hard for him to breathe. His heart muscle or valves may be damaged during surgery. He may have an irregular heartbeat or develop heart failure. The devices used to close the ASD may move out of place. Your child may need another surgery to fix this.
Care AgreementYou have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's healthcare providers to decide what care you want for your child. 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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