Paediatric Cardiac Surgery

Many times children get born with a heart defect and it is called a “congenital heart defect” while some of them develop some heart defects after birth. Depending on the seriousness paediatric heart surgeons suggest surgery for both cases. Most of the time, the families of the children get afraid in the name of surgery. However, it is important for them to repair heart defects and for the child’s well-being in the long term. In most cases, the children get fit after the surgery. So, it can be said there is no need of getting afraid. However, it is important to know everything about paediatric cardiac surgery and specifically, the symptoms to detect it in the early stage.

The symptoms of having a heart issue

The most important thing in treatment is the detection. Once the disease is detected, half of the journey is done. Here I will mention some common symptoms to detect that your child may have heart issues and inform your paediatrician for medical support.

(a) Infants- In the case of infants the symptoms are-
1.If your child gets out of breath with feeds
2.If your child gets sweaty with feeds
3.If your child has blue inside the mouth such as gums, tongue etc or it is getting blue with time.
4.If your child has blue or grey skin, lips, and nail beds.
5.Passing out
6.If your child has any problem with heart rate or heart rhythm (arrhythmias).
7.Poor feeding or sleeping, and lack of growth and development of the child.

(b) Toddlers- In the case of toddlers the symptoms are-
1.Unable to keep up physically with other children
2.Getting out of breath with activity sooner than other children
3.Getting sweaty with activity sooner than other children
4.Turning blue around the gums/tongue
5.Passing out

However, please keep in mind that every child is different. Some of them naturally sweat a lot while some of them sweat during sleep. Many children suffer from dizziness due to the lack of fluid in the body. Every child has different growth patterns & physical stamina as well. So don’t be scared. Consult with your paediatrician first.

The types of paediatric cardiac surgery

There are different types of heart defects detected in children. Some of them are minor and surgery can be avoided for months or years. On the other hand, many heart defects are serious and immediate surgery has been prescribed. There are three different types of surgeries to fix congenital defects and the surgeries are-

1. Open-heart surgery- The first process is open-heart surgery. In open-heart surgery, the surgeon uses a heart-lung bypass machine. In this open heart surgery, an incision is made through the breastbone (sternum) and this is done only after doing the anaesthesia. So that, the child does not feel any pain. In this surgery, the blood is redirected using tubes through a heart-lung bypass system, which is a unique pump. As the surgeon works to repair the heart, this device warms and circulates the blood throughout the remainder of the body while supplying it with oxygen.

2. Thoracotomy or closed-heart surgery- The second process is called thoracotomy or closed-heart surgery. In this process, an incision is made in the side of the chest, between the ribs. The surgery gets done by using a special instrument & a camera. No heart-lung bypass machine gets used in this process. Well, it is important to mention that not every heart defect can be treated in this way.

3. Cardiac catheterization: In some cases, the process called cardiac catheterization also gets used and in this process, the surgeon inserts small tubes into an artery in the leg and passes them up to the heart to fix the defect. However, just like the second process, it is also not applicable to every case.

Recovery time after the surgery

Right after the surgery, the child will be shifted to Paediatric Intensive Care Unit (PICU) for close monitoring by the doctors & nurses. Generally after one week, they get discharged from the hospital. However, it depends on the doctor & the condition of the patient. The wounds can take 8 to 12 weeks to recover fully. There will be a dressing on the wound and it is also natural to some dark brown looking ooze under the dressing. It is a sign of healing. Don’t get afraid.

Wound care at home

It has been prescribed that you should pay close attention to the wound if it is developing any redness, swelling, tenderness, warmth, or drainage. Make sure that your child should take only a shower or a sponge bath until your provider says otherwise. Steri-Strips should not be soaked in water. They will begin to peel off after the first week. It is ok to remove them when they start to peel off.
It is important to mention that if the wound is looking pink then your child should wear a bandage before going out to the sun.

After surgery precautions at home

Till one month after the surgery, your child should not do any kind of activity. Any kind of activity can cause a blow to the heart. Apart from this, you need to follow some points for the fast recovery of your child. The points are-
1. Do not pull or lift the child by the arms or from their armpit area. Scoop the child up instead.
2.Prevent your child from doing any activities that involve pulling or pushing with the arms.
3. Try to keep your child from lifting the arms above the head.
4. Make sure that your child does not lift any kind of weight.

Follow every instruction of your paediatrician and ask about the right of your child. The right diet helps in faster recovery as well.

When should you call your paediatrician?

1.If your child develops a fever, nausea, or vomiting
2.If your child is feeling any chest pain or other pain
3.If any redness, swelling, or drainage from the wound
4.In case of difficulty breathing or shortness of breath
5.If your child has puffy eyes or face
6.In case of tiredness all the time
7.In the case of bluish or greyish skin
8.In the case of dizziness, fainting, or heart palpitations
9.If there are any feeding problems or reduced appetite

Final words

Finally, I can say that undoubtedly it is a tough journey for the parents & the child, however, it can be handled if you detect it at the right time. Consult with your paediatrician & follow every instruction without any hesitation. If your child can talk, prepare him/her mentally for this journey.

Disclaimer

Though all attempts are made to provide correct information on the subject, inadvertent & typographical errors arising out of manual intervention cannot be ruled out. It is requested to bring any such discrepancies to the notice of the blogger for correction.