Heart surgery is performed in a special sterile room, called an EP laboratory, at a children’s hospital (operating room). The EP laboratory has heart monitors, X-ray table, and mapping equipment. The medical team includes the cardiac electrophysiologist, nurses, and technicians who are familiar with this type of procedure. Prior to insertion of the electrodes through the vein, the patient is cleaned and covered with sterile heat. The staff will be wearing sterile gowns and gloves in order to prevent infection. The surgery is performed by a specialized surgeon with training in cardiovascular surgery.
Closed Chest Heart Surgery:
Heart surgery is performed under general anesthesia and usually lasts for several hours. In this type of surgery, the anterior chest bone is not opened. The heart walls are not opened by the surgeon. Three examples of this type of surgery will be closure of a patent ductus arteriosus, surgical repair of coarctation of the aorta, and creation of a shunt.
Open Heart Surgery:
In this type of surgery, the anterior chest wall is opened. In most cases, it is the sternum (breast bone) that is opened by the surgeon. An example of heart surgery would be closure of a ventricular septal defect, repair of Tetralogy of Fallot, and AV canal.
In most cases, chest tubes are inserted to drain excess blood from the inner chest. The patients may leave the operating room intubated and connected to a respirator. Depending on the type of the surgery, the patient may be transferred to a specialized unit. The child may require temporary pacemaker leads (wires), which are usually pulled out a few days after surgery. Most patients will require multiple medications to help the heart recover faster and pump more effectively. Other medications are used to get rid of excessive fluid accumulation in the body.
The hospital stay may be a few days to one to two weeks. The average stay is usually less than one week. The surgeon will tell you how to take care of the incisions. A patient with a mid-sternotomy cannot be pulled up under the arms or lift weight. They should avoid any trauma to the chest for at least six weeks. Most patients are able to return back to their usual activities within six weeks after surgery. Be sure to ask Dr. Villafañe or the cardiovascular surgeon any questions that you may have.