Congenital heart defect corrective surgery

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Cardiac catheterization	Heart, front view	Heart, section through the middle	Patent ductus arteriosis (PDA) - series
Ultrasound, normal fetus - heartbeat	Ultrasound, normal fetus - heartbeat

After heart surgery, the child will be moved to the intensive care unit (ICU) to be constantly and closely monitored and treated for several days. During this time the child will have the following:

• A tube in the airway (endotracheal tube) and a respirator to help with breathing. The child will be kept sleeping (sedated) while on the respirator.
• One or more small tubes in a vein (IV line) to give fluids and medications.
• A small tube in an artery (arterial line) to measure the blood pressure.
• One or two chest tubes to drain air, blood, and fluid from the chest cavity.
• A tube through the nose into the stomach (nasogastric tube) to empty the stomach and give medications and/or feedings for several days.
• A tube in the bladder to drain and measure the urine for several days.

The child may also have pacemaker wires in the chest in case a pacemaker is needed to regulate heartbeat and rhythm.

SPECIFIC HEART DEFECT SURGERIES INCLUDE:

Patent ductus arteriosus (PDA) ligation

• Before birth, there is a natural opening between the aorta (the main artery to the body) and the pulmonary artery (the main artery to the lungs) called the ductus arteriosus. This opening usually closes shortly after birth. PDA occurs when this opening fails to close; PDA occurs in about 10% of infants.
• PDA is often treated initially with a medication called indomethacin. If the ductus fails to close on its own or with indomethacin, surgery is performed. A small incision is made on the left side of the chest. The ductus is either ligated (tied off) or cut.

Coarctation of the aorta repair

• Coarctation of the aorta occurs when a segment of the aorta has a very narrow spot, like that in an hourglass. To repair this defect, an incision is made on the left side of the chest.
• There are a few different techniques used in this repair. One approach is to remove the narrowed segment of the aorta and stitch the remaining ends together. This can usually be done in older children due to the size of the aorta.
• Repair in infants is usually achieved by using a subclavian flap. An incision is made in the narrowed portion of the aorta. A patch is made from a portion of the left subclavian artery (the artery to the arm) to enlarge the diameter of the aorta.