Definition:
Heart surgery in children is done to repair heart defects a child is born with (congenital heart defects) and heart diseases a child gets after birth that need surgery. The surgery is needed for the child’s well-being.
Alternative Names:
Heart surgery - pediatric; Heart surgery for children; Acquired heart disease, Heart valve surgery - children
Description:
There are many kinds of heart defects. Some are minor, and others are more serious. Defects can occur inside the heart or in the large blood vessels outside the heart. Some heart defects may need surgery right after the baby is born. For others, your child may be able to safely wait for months or years to have surgery. One surgery may be enough to repair the heart defect, but sometimes a series of procedures is needed. Three different techniques for fixing congenital defects of the heart in children are described below. Open-heart surgery is when the surgeon uses a heart-lung bypass machine. - An incision is made through the breastbone (sternum) while the child is under general anesthesia (the child is unconscious and does not feel pain).
- Tubes are used to re-route the blood through a special pump called a heart-lung bypass machine. This machine adds oxygen to the blood and keeps the blood warm and moving through the rest of the body while the surgeon is repairing the heart.
- Using the machine allows the heart to be stopped. Stopping the heart makes it possible to repair the heart muscle itself, the heart valves, or the blood vessels outside the heart. After the repair is done, the machine is removed, and the heart is started again. The breastbone and the skin incision are closed up.
For some heart defect repairs, the incision is made on the side of the chest, between the ribs. This is called a thoracotomy. It is sometimes called closed-heart surgery. This surgery is done using special instruments and a camera. Another way to fix defects in the heart is to insert a few small tubes into an artery in the leg and pass them up to the heart. Only some heart defects can be repaired this way. For more information about specific repairs, see: Congenital heart defect corrective surgeries
Why the Procedure Is Performed:
Some heart defects need repair soon after birth. For others, it is better to wait 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 (cyanosis). These symptoms mean there is not enough oxygen in the blood (hypoxia). Difficulty breathing because the lungs are "wet," congested, or filled with fluid (heart failure) Problems with heart rate or heart rhythm (arrhythmias) Poor feeding or sleeping, and lack of growth and development of a child
References:
Recommendations for preparing children and adolescents for invasive cardiac procedures: A statement from the American Heart Association Pediatric Nursing Subcommittee of the Council on Cardiovascular Nursing in collaboration with the Council on Cardiovascular Diseases of the Young. Circulation. 2003;108:2250-2564. Webb GD, Smallhorn JF, Therrien J, Redington AN. Congenital heart disease. In: Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 8th ed. St. Louis, Mo; WB Saunders; 2007:chap 61.
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