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Atrial Septal Defect Repair in Children—Open Heart Surgery

Authors:
  • Cynthia M. Johnson, MA
Publication Type:

Procedure

Atrial Septal Defect Repair in Children—Open Heart Surgery

Definition

An atrial septal defect is a hole in the wall between the two upper chambers (right and left atriums) of the heart. Open heart surgery can close the hole. The hole may be stitched shut, patched over, or plugged with a device. In about 6 months, the heart tissue will grow over the sutures or patch.

Patch Repair for Atrial Septal Defect.

Copyright © Nucleus Medical Media, Inc.

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Reasons for Procedure

An atrial septal defect can cause blood to flow backward into the right side of the heart and into the lungs. This triggers the heart to work harder. Over time, this can lead to damage to blood vessels in the lungs and congestive heart failure. This surgery is done to fix the hole.

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excessive bleeding
  • Problems from anesthesia, such as wheezing or sore throat
  • Infection, including endocarditis, an infection of the inner lining of the heart muscle
  • Blood clots
  • Damage to arteries
  • Heart rhythm problems

Things that may raise the risk of problems are:

  • Recent infection
  • Low birth weight

What to Expect

Problems to Look Out For

Call the doctor if your child is not getting better or has:

  • Signs of infection, such as fever and chills
  • Increased sweating
  • Redness, swelling, increasing pain, excessive bleeding, or any leaking from the wounds
  • Wounds that open
  • Nausea and vomiting
  • Lightheadedness
  • Pain that cannot be controlled with medicine
  • Lack of energy
  • Rash
  • Lack of hunger or poor feeding
  • Not been drinking enough fluids
  • Not been urinating

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies your child may have
  • Current medicines, herbs, and supplements that your child takes and whether your child needs to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Tests that will need to be done before surgery, such as images of the heart

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies your child may have
  • Current medicines, herbs, and supplements that your child takes and whether your child needs to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Tests that will need to be done before surgery, such as images of the heart

Anesthesia

General anesthesia will be used. Your child will be asleep.

Description of the Procedure

A cut will be made in the skin and breastbone. The chest will be opened. Next, the heart will be connected to a heart-lung machine. This machine will take over the work of the heart and lungs. The heart will be stopped to do surgery.

The pericardial sac around the heart will be opened. A small part of this sac may be removed and used to patch the hole. A cut will be made in the right atrium. A small hole will be closed with sutures. A larger hole will be covered with a patch or plug. The patch is made of tissue from the heart sac or other material. Once the defect is repaired, the cut will be closed. The heart will then be restarted. Once it is working fine, the heart-lung machine will not be needed. The chest will be closed. Sutures will be used to close the skin. A bandage will be placed over the area.

Immediately After Procedure

After the operation, your child will be taken to the intensive care unit (ICU) for observation.

How Long Will It Take?

2 to 4 hours

Will It Hurt?

Pain and swelling are common in the first 1 to 2 weeks. Medicine and home care can manage pain.

Average Hospital Stay

The usual length of stay is 5 to 7 days. If your child has any problems, he or she may need to stay longer.

Post-procedure Care

At the Hospital

Right after the procedure, the staff may:

  • Give your child pain medicines
  • Have your child lie still and flat for several hours to prevent bleeding

During your child's stay, the staff will take steps to lower the chance of infection such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your child's wounds covered

There are also steps you can take to lower your child's chances of infection such as:

  • Washing your hands and your child's hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your child's wounds

At Home

It will take about 6 weeks to fully heal. Physical activity will need to be limited during recovery. Your child may need to delay return to school.

RESOURCES:

CANADIAN RESOURCES:

CANADIAN RESOURCES:

References

  • Atrial septal defect. Cove Point Foundation website. Available at: http://www.pted.org/?id=atrialseptal4.
  • Atrial septal defect. Kids Health—Nemours Foundation website. Available at: https://www.kidshealth.org/en/parents/asd.html.
  • Atrial septal defects. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/atrial-septal-defects.
  • Pediatric open-heart surgery. Cincinnati Children’s Hospital website. Available at: https://www.cincinnatichildrens.org/health/o/open.

Contributors

  • Kari Kuenn, MD
Last Updated:
2022-12-01

(C) Copyright 2022 EBSCO Information Services

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.