Before Congenital Heart Surgery

Overview

Once your son/daughter has been referred for heart surgery, you will have a meeting with a cardiothoracic surgeon who will explain the operation and what will be done to help your child.

You will need to complete paperwork that gives your consent for the surgery. Typically, your child also will be scheduled for a “pre-operative work-up day.” Make sure that if you have questions about anything regarding your child’s condition or operation that you ask those questions and understand the answers.

Physicians and other healthcare providers understand that you may have no medical background, and they will be willing to explain things in a way that you understand. There is no such thing as a stupid question when it comes to your child’s health. If questions come up after a physician visit, write them down so that you can call or remember to ask the doctors at another time.

Pre-operative Testing

Pre-operative Testing

Before the  operation (usually the day before), your son/daughter will have a series of tests. These tests may include:

  • A short physical exam – You may want to bring an updated medical record if there have been changes in your child’s medical history.
  • Blood tests – Must be completed within a few days of surgery to ensure that the results are the most up to date. The blood will help show if your child’s liver and kidneys are working properly and also help match him/her with a blood donor in the event that a blood transfusion in required.
  • Chest x-ray – This test serves as a “pre-op baseline” to show the size and shape of your child’s heart and lungs.
  • Electrocardiogram (EKG) – A simple test that shows the pattern and rate of your child’s heart rhythm.

For more information on these tests, visit our common diagnostic tests page.

During the pre-operative work-up day, the medical staff will review what will happen  during the hospital stay. They also will answer any questions you may have. Some hospitals have specialists trained in child development available to explain procedures associated with the surgery based on your child’s needs and/or age. These specialists may also help with preparation on the day of the surgery.

At this point, you may be told what time to be at the hospital for the surgery; some practices will call the afternoon before surgery to give the time of surgery.

Some hospitals offer tours of the Intensive Care Unit (ICU) and post-operative hospital wards, where your son/daughter will go to recover after surgery. You are encouraged to familiarize yourself and your child with the hospital, its surroundings, and its resources in order to become comfortable with the hospital environment. Although hospitals sometimes appear scary to both parents and children, keep in mind that they exist purely to help you.

Planning for Surgery

Planning for Surgery

If your child is sick in any way during the week before the surgery, please take him/her to your pediatrician and call your surgeon’s office. If the operation is elective and your child has a viral infection, it is better to postpone the surgery in order to avoid infections or other complications in the post-operative period. 

Before surgery, it is essential that you notify your cardiothoracic surgeon of all medications or herbal supplements your son/daughter is taking, especially if he/she is taking blood thinners (anticoagulants). These can lead to excess bleeding during and after surgery, and usually need to be stopped prior to the scheduled operation.

These medications and supplements include, but are not limited to:

  • Anticoagulants: Warfarin (Coumadin)
  • Nonsteroidal anti-inflammatory drugs (NSAIDs): Aspirin
  • Antiarrhythmics: Digoxin (Lanoxin)
  • Beta blockers: Propranolol, Inderal
  • ACE inhibitors: Enalapril, Captopril, Lisinopril
  • Inhaled medications

If you have any questions about medications, please call the surgeon’s office or inquire on the day of your child’s pre-operative work-up.

The Night Before Surgery

The Night Before Surgery

Individual surgical practices will have different processes for the night before surgery. In general, the following hold true:

  1. Your child’s stomach must be empty before the operation. The nurse will tell you when your son/daughter should stop eating and drinking. Please refer to the section on medications for guidance on which ones you must stop giving your child before surgery.
  2. Bathe your child in the evening, washing the chest and side areas thoroughly for 5 minutes. Your surgeon may specify exactly what to use; if not, use an antibacterial soap, such as Dial liquid soap.
  3. It is important that your child be as comfortable as possible during his/her hospital stay. Pack a “comfort” item or two for your son/daughter, such as a favorite toy or blanket. Other helpful items include a small book, favorite music with player and earphones, or photographs. You might want to include things that are part of your child’s daily routine, such as eyeglasses, toothbrush and toothpaste, and schoolwork.
  4. After your child feels better in the ICU or moves to a step-down unit, he/she may want to wear pajamas from home. Make sure to label all items with your child’s name.

 

Reviewed by Lauren G. Kane, MD, and Pam Faire, CPNP
November 2016