Why is this procedure done?
An atrial septal defect is an ASD. It is a hole in the heart. The hole is between the two upper chambers of the heart. It is a congenital heart defect which means that your child is born with it. This hole gets in the way of the normal flow of blood through the heart. It allows blood to back up in the lungs. It can cause serious problems like trouble breathing, poor growth, lung problems, and tiredness during activity. ‚
An ASD can be fixed in one of two ways. It may be fixed with open heart surgery or, sometimes, with a special heart catheter. Your childs doctor will talk to you about which procedure is the best one for your child. Open heart surgery is any procedure that opens the chest and repairs the heart. ‚
Open heart surgery is most often done for patients: ‚
- With large holes
- With other heart defects
- With an enlarged heart
- Who cannot undergo a heart cath. This is where a tube is put into a vein to fix the hole.
- With too much blood in the right side of the heart. This is right ventricular overload.
- With too much blood going to the body, then into the lungs
View OriginalView Original
View OriginalView Original
View OriginalView Original
What will the results be?
Your childs doctor will stitch the hole or cover it with a patch during the surgery. This will close the hole between the two upper chambers of your child's heart. The flow of blood through the heart should return to normal. ‚
What happens before the procedure?
- Your doctor will take your childs history. Talk to the doctor about:
- All the drugs your child is taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs your child takes with you.
- Any bleeding problems. Be sure to tell the doctor if you are giving your child any drugs that may cause bleeding. Some of these are Coumadin ‚ ®, ibuprofen, Aleve ‚ ® (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. Your child may need to stop these drugs as well. Talk to your doctor about them.
- If your child has an illness like a cold or sore throat. This may raise the risk of infection.
- When your child needs to stop eating or drinking before the procedure.
- If necessary, your doctor will talk with you about what kind of patch is best for your child. Some patches are made of pieces of the heart's tissue, of silk, or of man-made material such as Dacron ‚ ® or Teflon ‚ ®.
- Your child's doctor will do an exam and may order:
- A recording of your child's heartbeats. You may hear this called an ECG or EKG.
- A test that uses sound waves to make a moving picture of your child's heart. This is an echocardiogram or Echo or 2-D Echo. It is a type of ultrasound of the heart.
- Lab tests
- A picture of your child's chest. This is a chest x-ray.
- You will be asked to sign a consent form for your child before the surgery. You will be told about other options as well as any risks or possible problems. Make sure you ask questions if you do not understand what will occur.
- You may be asked to give your child a bath with a special soap. This will help prevent infections.
- Your child may be given drugs to prevent infection before and after the surgery.
What happens during the procedure?
- Once your child is in the operating room, they will be given a drug to make them sleepy. It will also help your child stay pain free during the surgery. After your child is asleep, the doctor will put a tube in the mouth to help your child breathe. The staff will put an I.V. in your childs arm to give fluid and drugs. They may also put another small tube in your child's nose. This one goes down into your child's stomach to drain out any fluid or food that might come out during surgery. Your child may have a tube in the bladder to drain urine.
- Monitors will keep track of your child's blood pressure and heart rate.
- The doctor will clean your child's chest. The chest will be opened so the doctor can see your child's heart and where to operate. The doctor will put tubes into your child's big blood vessels. These will be hooked to a heart-lung machine. The machine acts as your child's heart and lungs while the doctor operates on your child. After hooking your child to a heart-lung machine, the doctor will stop your child's heart from pumping.
- Your doctor will cut into your child's heart. The doctor will close the hole with stitches or will place a patch over the hole. Once the defect is closed, the doctor will close the heart.
- Your doctor will make your child's heart start again. Then, the doctor will unhook your child from the heart-lung machine. The skin is stitched shut and the cut site is covered with a bandage.
- The procedure takes about 1 to 3 hours.
What happens after the procedure?
- Your child will go to the Intensive Care Unit (ICU) after surgery. The staff will watch your child very closely. They will also give your child drugs for pain through the I.V. as needed.
- After surgery, your child may be on a breathing machine called a ventilator. The staff will take out the breathing tube when your child is awake and strong enough to breathe on his own.
- The doctor will move your child to a regular hospital room when your child is stable and off the ventilator.
- Your child will stay in the hospital for at least 3 to 4 days after surgery.
What drugs may be needed?
The doctor may order drugs to: ‚
- Help with pain
- Prevent infection
- Prevent blood clots
What problems could happen?
- Bleeding
- Fluid around the heart. This is a pericardial effusion.
- Infection
- Blood clots
- Lung problems
- Air blocks a blood vessel. This is an air embolism.
Helpful tips
- Talk to your childs dentist about the ASD repair. Your child may need to take drugs to prevent infection before going to the dentist. This is most often needed only during the first 6 months after surgery.
Where can I learn more?
American Heart Association ‚
http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/CareTreatmentforCongenitalHeartDefects/Congenital-Heart-Defects-Surgery_UCM_307729_Article.jsp ‚
Congenital Heart Information Network ‚
http://tchin.org/resource_room/c_art_14.htm ‚
KidsHealth ‚
http://kidshealth.org/parent/medical/heart/asd.html ‚
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
Copyright
Copyright ‚ © 2015 Clinical Drug Information, LLC and Lexi-Comp, Inc. ‚