Quick facts
Treatment type
Open heart surgery for children
Hospital stay
Commonly 1-2 weeks, including paediatric ICU
Return to activities
4-6 weeks
Anaesthesia
General
What is it
Paediatric open heart surgery repairs heart defects in babies and children. The chest is opened and the repair is carried out with the support of a heart-lung machine, by a team trained specifically in children's heart surgery.
Why it is done
Many heart defects a child is born with will not close or correct themselves. Repairing them restores normal blood flow, protects the lungs and the heart muscle, and allows the child to grow, feed and develop normally.
Who needs it
A large hole in the heart, such as a ventricular or atrial septal defect
Tetralogy of Fallot and other complex defects
Narrowed or leaking valves
Abnormal connections between the heart's chambers or great vessels
Signs that bring a child to surgery include poor feeding and slow weight gain, fast or laboured breathing, frequent chest infections, tiring easily, and blue lips or fingertips.
Types and options
Corrective surgery - a single operation that repairs the defect completely.
Palliative surgery - an operation such as a shunt that improves blood flow first, with full repair planned later.
Staged surgery - a planned series of operations for complex defects, done as the child grows.
Tests before treatment
Echocardiography, the main test, sometimes from before birth
ECG
Chest X-ray
Cardiac CT or MRI for complex anatomy
Cardiac catheterisation where pressures need to be measured
Blood tests and an assessment of growth, feeding and general health
How it is done
The operation is carried out under general anaesthetic by a paediatric cardiac team, with the heart-lung machine taking over the work of the heart while the repair is made.
Recovery
A few days in the paediatric cardiac intensive care unit, then the ward, with a total stay commonly of about one to two weeks depending on the defect. Children usually return to normal activity over four to six weeks and recover faster than adults. Regular follow-up with echocardiography checks the repair, and growth and feeding usually improve markedly afterwards.
Benefits and outcomes
Corrects the defect and restores normal blood flow
Protects the lungs and heart muscle from long-term damage
Improves feeding, weight gain and growth
Allows the child to be active and to develop normally
For many defects, a single operation is a lifelong repair
Risks and complications
Bleeding
Infection, including of the wound or chest
Abnormal heart rhythm, occasionally needing a pacemaker
Fluid around the heart or lungs
Effects on kidney or lung function after bypass
Rarely, stroke or neurological complications
A residual defect or leak that needs further treatment
Preparing to travel
Complete cardiac evaluation and imaging
Treat any active infection before surgery
Blood tests and cross-matching
Meet the surgical, anaesthetic and intensive care teams
Follow instructions about feeding and medicines before admission
Prepare for a parent to stay with the child
How it is done
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1
Anaesthesia
The child is given a general anaesthetic and monitoring lines are placed by the paediatric cardiac anaesthetist.
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2
Access
The chest is opened, usually through the breastbone, to reach the heart.
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3
Heart-lung support
The child is placed on the heart-lung machine so the heart can be stopped and opened safely.
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4
The repair
The defect is closed or corrected, using a patch or the child's own tissue as required.
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5
Coming off bypass
The heart is restarted, the repair is checked on echo, and the heart-lung machine is withdrawn.
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6
Intensive care
The chest is closed and the child is cared for in the paediatric cardiac intensive care unit.
Where you can have this
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What it costs
What changes the price
The defect and the complexity of the repair
Whether the repair is single-stage or staged
Age and weight of the child
Time needed in paediatric intensive care
Hospital selected
Paediatric cardiac surgeon and team
Length of stay and any complications
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