What to Expect at Home

Your child will need at least 3 or 4 more weeks at home to recover. For larger surgeries, recovery may take 6 to 8 weeks. Talk with your child's doctor about when your child can return to school, daycare, or participate in sports.

Pain after surgery is normal. There may be more pain after closed-heart surgery, compared to open-heart surgery. This is because nerves may have been irritated or cut. Usually, the pain is minimal after the second day and is easily managed with acetaminophen (Tylenol).

Many children behave differently after heart surgery. They may be clingy, irritable, have nightmares, wet the bed, or cry. They may do these things even if they were not doing them before their surgery. Support your child through this time, and slowly begin to set the limits that were in place before the surgery.

Activity

If your child is an infant, try not to let them cry for too long for the first 3 to 4 weeks. Help keep them calm by staying calm yourself. When lifting your child, support both their head and bottom for the first 4 to 6 weeks.

Toddlers and older children will often stop any activity if they become tired.

The doctor or nurse will tell you when it is okay for your child to return to school or daycare.

• Most often, the first few weeks after surgery should be a time to rest.
• After the first follow-up visit, the doctor will tell you what the child can do.

For the first 4 weeks after surgery, your child should not do any activity where there is a chance they could fall or take a blow to the chest. Your child also should avoid bicycle or skateboard riding, roller skating, and all contact sports.

Your child may climb stairs, and swimming is okay after their Steri-Strips have fallen off.

If your child has an incision through the breastbone, you must be careful how they use their arms and upper body for the first 6 to 8 weeks:

• Do not pull or lift the child by their arms. Scoop them up instead.
• Your child should not do any activities that involve pulling or pushing their arms.
• Try to keep your child from lifting their arms above their head.
• Your child should not lift anything heavier than 5 pounds.

Diet

Keep a close eye on your child’s diet to make sure they get enough calories to heal and grow.

After heart surgery, most babies and infants (younger than 12 to 15 months) can take as much formula or breast milk as they want. Sometimes the doctor may want your baby not to drink too much formula or breast milk. Ask your child’s doctor any other questions about your child's nutrition.

Limit feeding time to around 30 minutes. Your child’s doctor or nurse will tell you how to add extra calories to formula.

Toddlers and older children should be given a regular, healthy diet. The doctor or nurse will tell you how to improve the child's diet after surgery.

Wound Care

Wash all the incisions, once a day with soap and water. Pat them dry. Look at the wound for signs of infection, which are redness, swelling, and drainage.

Your child should take only a shower or a sponge bath. Their Steri-Strips should NOT soak in the water. Steri-Strips will begin to peel off after the first week. It is okay to remove them when they start to peel off.

For as long as the scar looks pink, make sure it is covered with clothing or a bandage when your child is in the sun.

Follow-up

Ask your child’s doctor before getting any immunizations for 2 to 3 months after surgery. Afterwards, your child should have a flu shot every year.

Many children who have had heart surgery must take antibiotics before, and sometimes after, having any dental work. Make sure you have clear instructions from your child’s heart doctor when the child needs antibiotics. It is still very important to have your child's teeth cleaned regularly.

Your child may need to take medicine when they are sent home. These may include diuretics (water pills) and other heart medicines. Be sure to follow the correct dosage. Follow up with your doctor 1 to 2 weeks after the child leave the hospital.

When to Call the Doctor

Call the doctor if your child has:

• Fever, nausea, or vomiting
• Chest pain, or other pain
• Redness, swelling, or drainage from the wound
• Difficulty breathing or shortness of breath
• Puffy eyes or face
• Tiredness all the time
• Bluish or grayish skin
• Dizziness, fainting, or heart palpitations
• Feeding problems or reduced appetite

Alternate Names

Congenital heart surgery - discharge; Patent ductus arteriosus ligation - discharge; Hypoplastic left heart repair - discharge; Tetralogy of Fallot repair - discharge; Coarctation of the aorta repair - discharge; Heart surgery for children - discharge; Atrial septal defect repair - discharge; Ventricular septal defect repair - discharge; Truncus arteriosus repair - discharge; Total anomalous pulmonary artery correction - discharge; Transposition of great vessels repair - discharge; Tricuspid atresia repair - discharge; VSD repair - discharge; ASD repair - discharge; PDA ligation - discharge; Acquired heart disease - discharge; Heart valve surgery - children - discharge; Heart surgery - pediatric - discharge; Heart transplant - pediatric - discharge

References

Pigula FA, Del Nido, PJ. Neonatal and infant cardiac surgery. In: Keane JF, Lock JE, Fyler DC, eds. Nadas’ Pediatric Cardiology, 2nd ed. St. Louis, Mo; WB Saunders; 2006:chap 57.

Recommendations for preparing children and adolescents for invasive cardiac procedures: A statement from the American Heart Association Pediatric Nursing Subcommittee of the Council on Cardiovascular Nursing in collaboration with the Council on Cardiovascular Diseases of the Young. Circulation. 2003;108:2250-2564.

Webb GD, Smallhorn JF, Therrien J, Redington AN. Congenital heart disease. In: Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 8th ed. St. Louis, Mo; WB Saunders; 2007:chap 61.

Update Date: 7/27/2012

Updated by: Shabir Bhimji MD, PhD, Pediatric and General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.