What is Involved in Pediatric Heart Surgery?

In pediatric heart surgery, a surgeon will repair damage or defects in a child's heart to address health problems associated with structural abnormalities, disease, and other issues. This procedure may occur shortly after birth in the case of children with birth defects, or could take place later in childhood for children with acquired heart injuries or mild congenital problems that become worse. Patients may spend several days or weeks in the hospital after surgery, depending on their overall health and the reason for the surgery.

The first step in pediatric heart surgery is an evaluation of the patient. The surgeon will use medical imaging and other tools to assess heart function and learn as much as possible about the condition of the heart. Doctors can also order bloodwork to check for risks that might complicate the surgery, and they will collect a detailed history on the patient and her parents. Surgeons incorporate this information into a plan for the procedure with the goal of completing the surgery quickly and safely.

On the day of the pediatric heart surgery, the child needs to fast to reduce risks from anesthesia. An anesthesiologist will induce anesthesia and monitor the patient during the procedure for signs of distress. For open heart surgery, the surgeon opens up the sternum. In a less invasive procedure called a thoracotomy, the surgeon goes in through the ribs, using cameras to visualize the surgical site. Next, cardiac bypass begins, with a machine taking over for the child's heart to allow the surgeon to operate on the heart and surrounding structures while the heart is still and mostly bloodless. In some procedures, the heart may be left beating.

After the surgeon is satisfied with the repair and the patient's heart is beating successfully, the team closes the surgical site and moves the child into recovery. During recovery from pediatric heart surgery, patients usually need to be active to reduce the risk of blood clots, and they need to do regular breathing exercises to develop lung strength and function in the wake of the surgery. Pain management is also a part of the aftercare plan, to make sure a child has adequate analgesia.

Parents often worry about pediatric heart surgery because it can sound frightening. Facilities offering this service rely on highly trained and very experienced specialists. Large surgical teams monitor patients throughout surgery and followups include detailed examinations and overviews of the patient's health to catch complications early. Parents can ask where surgeons trained and how long they have been practicing medicine. It may also be helpful to ask for statistics on patient outcomes with similar procedures.