During Heart Surgery

Heart surgery usually takes between two and eight hours, although a lot of this time is used for the safe preparation of your child before surgery and the careful stabilization of your child as surgery is finishing.

Preparing for Surgery

Just before surgery begins, your child will be attached to a heart monitor that shows heart rate and rhythm. Then your child is given anesthesia to keep her asleep during the operation. An anesthesiologist is present to monitor this procedure and to check vital signs during surgery.

Once asleep, a breathing tube (called an endotracheal or ET tube) is put in your child's windpipe. It is attached to a breathing machine (ventilator or respirator). In addition, intravenous (IV) tubes are put into the veins to give your child medicines and fluids.

A special tube (arterial line) is put in an artery, the blood vessel where you can feel a pulse, to continually monitor blood pressure. A small monitor device called a pulse oximeter is attached to a finger with tape. This indirectly measures the amount of oxygen in the blood.

Once the breathing, blood pressure, and blood oxygen are taken care of, it is time to take care of the stomach, kidneys, and bladder before surgery can begin. Your child's stomach does not know that it won't be getting food for a while and will continue to make juices that help digest food. Having these juices in the stomach without food may cause a person to vomit. To prevent this, a nasogastric tube (NG tube) is placed in the nose down to the stomach to empty it.

The kidneys must work pretty hard during surgery to get rid of any fluids given through the IVs. To measure the urine, a tube is put into the bladder through the urinary opening which is then attached to a device which drains and measures the urine.

When you visit your child after surgery, all or some of these tubes and devices may still be still present. They are nothing to get scared about as they simply help your child's body to function normally during and immediately after the surgery.

Surgery Starts

To gain access to the heart, the surgeon will make an incision. The location of the incision depends on the type of surgery and whether cardiopulmonary bypass (the heart-lung machine) will be used.

During open heart surgery your child is hooked up to a heart-lung machine. As the end of surgery nears, your child is gradually taken off this machine and blood flow is returned through the heart and lungs.

To allow extra fluid and blood to drain out after surgery, the surgeon will add chest tubes. He may also add temporary pacemaker wires, connected to a small temporary pacemaker outside the body that permit the doctors to control your child’s heart rhythm after surgery, if necessary. Removing these wires will be done before the child returns home -- no surgery is required.

If the sternum (or breastbone) has been opened, it will be closed, either with sutures (stitches) or wires. The incision on the inside of the chest is closed with special stitches that later dissolve. The outside skin is held together with absorbable sutures and adhesive strips. If a side incision is used, then the breastbone won’t need to be cut and no wires are used.