Wednesday, January 25, 2023

What To Expect After Infant Open-heart Surgery

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Your Eating Habits May Change

Inside the NICU: Successful Open-Heart Surgery for This Newborn

You may notice that youve lost your appetite or you just feel too tired to eat. This is common, so be patient. Your appetite will soon be back to normal.

We suggest you try eating frequent, small meals throughout the day. You need proper nutrition to enable your body to heal and get stronger.

We recommend a diet low in fat, cholesterol and sodium and high in protein. Good sources of protein include fish, eggs, dairy, beans and nuts. Limit the amount of salt in your diet to 2,000 milligrams a day. Foods known to be high in salt include restaurant food, soups, pizza, bacon and other processed meats.

What To Expect After Cardiac Surgery

After cardiac surgery, children are usually transferred to the Paediatric Intensive Care Unit for close monitoring by specialist nurses and doctors. Immediate family members are encouraged to visit children in PICU, however, please note that visitor numbers are limited. Overnight accommodation is very limited for parents of children in PICU so you will need to be prepared to return home .

During this phase, your child will have several tubes and wires attached to them which can be confronting at first but it is important to remember that this is part of the normal recovery process for children who have had heart surgery. As they recover, these will be removed. Once stable, your child will be transferred to the cardiac inpatient ward. The staff in the PICU will support you through your childs stay. PICU also has a Social Work Team who are available to provide support to you and your family.

The Night Before Surgery

A nurse in the preoperative surgery area will call you to tell you what time to be at the hospital for the surgery. Please call your surgeons office if you have not heard anything by late afternoon the day before the surgery.

  • Your childs stomach must be empty before the surgery. The nurse will tell you when your child should stop eating and drinking.
  • Bathe your child in the evening, washing the chest and side areas really well for five minutes. You may use your child’s regular shampoo and bathing supplies for the preoperative bath. Please avoid using lotions or creams afterwards.
  • Pack a comfort item or two for your child, such as a favorite toy or blanket. Other helpful items include a small book, favorite music with player and earphones, or photographs. Bring your childs eyeglasses, toothbrush and toothpaste and schoolwork too.
  • After your child feels better and moves out of the ICU, your child may want to wear pajamas from home. Make sure to label all items with your childs name.

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You May Feel Like Youre On An Emotional Roller Coaster

Recovering from open-heart surgery involves physical and emotional healing. The recovery process uses emotional and physical energy.

If you feel upset or emotional in the weeks after your operation, dont worry this is a normal reaction. Many patients report these feelings up to three months after the operation:

  • Mood swings that may include depression, fear, anxiety, loneliness, helplessness and anger

  • Crying easily for no apparent reason

  • Lack of energy or motivation

  • Getting easily frustrated

  • Having good days and bad days

  • Feeling more emotional or sentimental than normal

Even though you may feel drained physically and emotionally, its important to follow guidelines for good self-care:

  • Get dressed every day

  • Walk daily within your limits

  • Get plenty of rest

What Are The Signs And Symptoms Of Congenital Heart Defects

miracle baby smiles after surviving open heart surgery at just four

Many congenital heart defects have few or no signs or symptoms. A doctor may not even detect signs of a heart defect during a physical exam.

Some heart defects do have signs and symptoms. They depend on the number, type, and severity of the defects. Severe defects can cause signs and symptoms, usually in newborns. These signs and symptoms may include:

  • Rapid breathing

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Why The Procedure Is Performed

Some heart defects need repair soon after birth. For others, it is better to wait weeks, months, or years. Certain heart defects may not need to be repaired.

In general, symptoms that indicate that surgery is needed are:

  • Blue or gray skin, lips, and nail beds . These symptoms mean there is not enough oxygen in the blood .
  • Difficulty breathing because the lungs are “wet,” congested, or filled with fluid .
  • Problems with heart rate or heart rhythm .
  • Poor feeding or sleeping, and lack of growth and development of the child.

Types Of Congenital Heart Defects

Congenital heart defects change the normal flow of blood through the heart. This is because some part of the heart didn’t develop properly before birth.

There are many types of congenital heart defects. Some are simple, such as a hole in the septum that allows blood from the left and right sides of the heart to mix, or a narrowed valve that blocks blood flow to the lungs or other parts of the body.

Other defects are more complex. These include combinations of simple defects, problems with where the blood vessels leading to and from the heart are located, and more serious problems with how the heart develops.

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What Problems Can Happen

An ASD that isn’t treated in childhood can lead to health problems later, including an abnormal heart rhythm and problems in how well the heart pumps blood.

As kids with ASDs get older, they also might be at an increased risk for stroke because a blood clot could form, pass through the hole in the septum, and travel to the brain. Pulmonary hypertension also may develop over time in older patients with larger untreated ASDs.

Because of these possible complications, doctors usually recommend closing ASDs early in childhood.

Why Choose Norton Childrens Heart Institute

Open Heart Surgery: What to Expect (English CC)
  • Norton Childrens Hospital has been a pioneer in pediatric cardiothoracic surgery, performing Kentuckys first pediatric heart transplant in 1986 and becoming the second site in the United States to perform an infant heart transplant.
  • The American Board of Thoracic Surgery has certified our cardiothoracic surgeons in congenital heart surgery.
  • The Adult Congenital Heart Association has accredited Norton Childrens Heart Institutes Adult Congenital Heart Program as the only comprehensive care center in Kentucky and Indiana treating adults born with a heart defect.
  • More than 5,000 children a year visit Norton Childrens Heart Institute for advanced heart care.
  • Norton Childrens Heart Institute has offices across Kentucky and Southern Indiana to bring quality pediatric heart care closer to home.
  • The Jennifer Lawrence Cardiac Intensive Care Unit at Norton Childrens Hospital is the largest dedicated CICU in Kentucky, equipped with 17 private rooms and the newest technology available for heart care.

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In This Video Learn Reasons Doctors Use Open

Heart surgery is one of the marvels of modern healthcare. Doctors of the 1800s initially believed surgery on the heart was impossible and were hesitant to even try. Starting in the 1950s, thanks to determined and brilliant surgeons, open-heart surgeries became increasingly safer, more common, and more effective.

Despite the medical progress, patients and their loved ones are understandably anxious about their surgery dateand what their life will be like in the weeks and months following the procedure.

Open-heart surgery is actually a group of procedures. We can do surgery on the heart for many different reasons, says Michelle Weisfelner Bloom, MD, cardiologist at Stony Brook University Medical Center. The most common surgery is coronary artery bypass grafting, or CABG.

When Is Open-Heart Surgery Beneficial?

Patients might benefit from open-heart surgery for one of a few reasons, according to Dr. Weisfelner Bloom.

What to Expect After Open-Heart Surgery

After waking up from your surgery, you will likely feel confused and tired. You will be hooked up to wires and tubes and will be in the Intensive Care Unit with highly trained healthcare professionals. Your wrists may be gently strapped down to prevent you from accidentally pulling out any of the tubes.

Recovering from Open-Heart Surgery

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How The Heart Works

To understand congenital heart defects, it’s helpful to know how a normal heart works. Your child’s heart is a muscle about the size of his or her fist. It works like a pump and beats 100,000 times a day.

The heart has two sides, separated by an inner wall called the septum. The right side of the heart pumps blood to the lungs to pick up oxygen. Then, oxygen-rich blood returns from the lungs to the left side of the heart, and the left side pumps it to the body.

The heart has four chambers and four valves and is connected to various blood vessels. Veins are the blood vessels that carry blood from the body to the heart. Arteries are the blood vessels that carry blood away from the heart to the body.

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What Information Do I Need Before I Go Home

  • Your childs nurse will give you printed instructions for care at home after the surgery. These instructions include how to take care of the incision, what activities are allowed, what your child can or cannot eat, medications, when to call the doctors and follow-up appointments.
  • Your child will come back to the hospital for at least one check-up with the surgical team in the first one to two weeks after going home. During this appointment, the team will check your childs incision and remove any remaining stitches.
  • You will need to schedule a follow-up appointment with your cardiologist and pediatrician in the first one to two weeks after going home. A full medical summary of your childs surgery will be sent to your pediatrician and cardiologist, who will continue to manage your childs care at home.
  • If your child needs any medical equipment to return home, your nurse and care coordinator will work closely with you to order it. They will arrange home nursing visits if needed.
  • Please call your surgeons office at any time if your child has any of the following symptoms: fever, redness, swelling or drainage at the incision site.

Handling Your Baby After Surgery

Just 5 days old, our baby boy underwent his first of 3 open heart ...

To ensure your that babys wound heals evenly, it is important not to pick them up under their arms for a period of 6 weeks. The nursing staff will teach you how to pick you baby up using the scoop technique. When you go home it is important that you teach anyone who might pick up you baby how to do so correctly.

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What Else Do I Need To Know

Dental Care

People with heart problems may be more likely to get endocarditis after routine dental care or some types of surgery. This can occur when bacteria that are normally found in the mouth enter the bloodstream and travel to the heart.

The risk of endocarditis is reduced with good dental care. Brush their teeth at least twice a day. Clean your infant’s teeth with a washcloth wrapped around your finger.

Your child should begin seeing a dentist between 2-3 years of age to keep the mouth healthy. Tell your dentist about your child’s heart condition. For dental procedures and some surgeries, an antibiotic may be needed before and after the appointment. Check with your cardiologist if you have questions about the need for antibiotics. No dental procedures should be done for at least 6 weeks after surgery.

Behavioral

Your child may be moody or irritable after surgery or hospital stays. If you become concerned, call your pediatrician.

Toddlers and preschoolers may go back to earlier behaviors in areas such as toilet training and independence, and may have more separation anxiety for a while. They should regain these skills after some time.

Toddlers and preschoolers may have nightmares for a short time. Reassure and comfort them to help them go back to sleep.

You May Experience Sleep Issues

Many people complain of having trouble sleeping for some time after heart surgery. You may experience insomnia because of:

  • Effects of anesthesia

  • Changes in your daily routine

  • Stress from personal concerns

Normal sleeping patterns typically return in two to three weeks. Until then, try these tips:

  • Take enough rest breaks in between your normal daily activities but avoid a daytime nap longer than 20 minutes.

  • If you have pain, take your pain medication about 30 minutes before bedtime.

  • Arrange the pillows so you can maintain a comfortable position and decrease muscle strain.

  • If you feel anxious or nervous, talk to your spouse, partner or a trusted friend. Get your troubles off your mind.

  • Avoid caffeine in the evenings.

  • Listen to relaxing music or a guided imagery audio program.

  • Ask your partner to give you a back rub.

  • Take a relaxing shower.

  • Follow a bedtime routine to let your body know its time to relax and get to sleep.

  • Its OK to sleep on your back, side or stomach. You will not hurt your incisions.

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What Causes Congenital Heart Defects

If you have a child who has a congenital heart defect, you may think you did something wrong during your pregnancy to cause the problem. However, most of the time doctors don’t know why congenital heart defects develop.

Heredity may play a role in some heart defects. For example, a parent who has a congenital heart defect may be more likely than other people to have a child with the condition. In rare cases, more than one child in a family is born with a heart defect.

Children who have genetic disorders, such as Down syndrome, often have congenital heart defects. In fact, half of all babies who have Down syndrome have congenital heart defects.

Smoking during pregnancy also has been linked to several congenital heart defects, including septal defects.

Scientists continue to search for the causes of congenital heart defects.

How Are Atrial Septal Defects Treated

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Treatment of an ASD will depend on a child’s age and the size, location, and severity of the defect.

Very small ASDs might not need any treatment. In other cases, the cardiologist may recommend follow-up visits for observation.

Usually, though, if an ASD hasn’t closed on its own by the time a child starts school, the cardiologist will recommend fixing the hole, either with cardiac catheterization or heart surgery.

Cardiac Catheterization

Many ASDs can be treated with cardiac catheterization. In this procedure, a thin, flexible tube is inserted into a blood vessel in the leg that leads to the heart. The cardiologist guides the tube into the heart to make measurements of blood flow, pressure, and oxygen levels in the heart chambers. A special implant is positioned into the hole and is designed to flatten against the septum on both sides to close and permanently seal the ASD.

In the beginning, the natural pressure in the heart holds the device in place. Over time, the normal tissue of the heart grows over the implant and covers it entirely. This nonsurgical technique leaves no chest scar, has a shorter recovery time than heart surgery, and usually needs just an overnight stay in the hospital.

After catheterization, a child should take it easy for a few days and might need to skip gym class or sports practice for a week or two.

Heart Surgery

Your doctor will discuss other possible risks and complications with you before the procedure.

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Leaving Hospital After A Heart Operation

This page from Great Ormond Street Hospital explains how to look after your child when they return home after heart surgery.

If you see any of these signs in your child on either of their wound site or chest drain site:

  • Your child is generally unwell
  • They have a high temperature
  • The site is redder than before and/or the redness is spreading
  • The site feels hotter than the surrounding skin
  • The site is oozing any fluid
  • The site becomes swollen
  • The site begins to smell
  • Your child is complaining of pain at the site

Open Heart Surgery Complications And After Care

Heart-lung bypass safety has improved over the years. Serious complications are very rare. Patients can be on a heart-lung machine for four to eight hours and recover well.

  • Air or particles creating a clot that could lead to stroke or a seizure
  • Low blood flow to the bodys organs or tissue

Bleeding also is a risk after open heart surgery. A blood-thinning medication called heparin is used while the patient is on the heart-lung machine. Bleeding sometimes happens where surgeons have placed stitches. This bleeding usually is not severe and is controlled directly by the surgeon, or with medications and blood products. Occasionally, postoperative bleeding may require another operation.

Complications during and after pediatric heart surgery can include:

  • Heart rhythm abnormalities. Certain repairs require many stitches inside the heart. These stitches can disrupt the invisible electrical system of the heart. This can be a temporary complication or a permanent complication. If permanent, the childs normal rhythm can be restored with a pacemaker.

The child is monitored very closely after open heart surgery. Every childs heals at their own pace. Each day the child is in the hospital, the care team will talk about how the child is doing and help create a care plan to get the child closer to going home.

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What To Expect At Home

Your child will need at least 3 or 4 more weeks at home to recover. For larger surgeries, recovery may take 6 to 8 weeks. Talk with your child’s health care provider about when your child can return to school, daycare, or take part in sports.

Pain after surgery is normal. There may be more pain after closed-heart surgery than after open-heart surgery. This is because nerves may have been irritated or cut. The pain will likely decrease after the second day and can sometimes be managed with acetaminophen .

Many children behave differently after heart surgery. They may be clingy, irritable, wet the bed, or cry. They may do these things even if they were not doing them before their surgery. Support your child through this time. Slowly begin to set the limits that were in place before the surgery.

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