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Open heart surgery is a term used to describe how surgeons at Norton Children’s Heart Institute repair children’s hearts with congenital heart defects. Following an incision in the middle of the chest, a patient’s heart is opened through an incision, allowing the pediatric cardiothoracic surgeon to look into the heart and make the repair. During pediatric heart surgery, the patient is placed on a heart-lung (cardiopulmonary) bypass machine, which does the heart’s work of pumping blood to the brain and body while the surgeons operate.
A bypass machine is not used in every open heart surgery. Norton Children’s Heart Institute surgeons can complete some pediatric heart surgeries while the heart is beating, but not pumping blood. Sometimes, this is possible when the repair is on the right side of the heart and there are no holes between the left and right sides of the heart.
When surgeons do use a bypass machine, they can stop the heart once the heart-lung bypass machine has taken over doing the work of the heart and lungs so the complex repair can be best performed. When the heart is stopped, the surgeons use a cold, high-potassium solution called cardioplegia solution that stops the heart and protects the heart muscle.
When the repair is complete, the surgeons can safely remove the bypass machine and restart the heart.
Open heart surgery is used to repair numerous congenital heart defects, such as:
Children who need open heart surgery will have a complete exam from the Norton Children’s Heart Institute team. The exam usually includes blood work, a chest X-ray, an electrocardiogram, an echocardiogram and possibly heart catheterization prior to surgery. The information gathered from these tests helps guide the surgery plan and after-surgery care.
The board-certified and fellowship-trained cardiothoracic surgeons at Norton Children’s Heart Institute have the sophisticated tools, experience and training to identify which cases require open heart surgery and when they can use less-invasive treatments.
Norton Children’s Heart Institute is the leading provider of pediatric heart care in Louisville and Southern Indiana.
Norton Children’s has a network of outreach diagnostic and treatment services conveniently located throughout Kentucky and Southern Indiana.
The surgeon will:
Heart-lung (cardiopulmonary) bypass safety has improved over the years. Serious complications are very rare. Patients can be on a heart-lung machine for four to eight hours and recover well.
Bypass risks include:
Bleeding also is a risk after open heart surgery. A blood-thinning medication called heparin is used while the patient is on the heart-lung machine. Bleeding sometimes happens where surgeons have placed stitches. This bleeding usually is not severe and is controlled directly by the surgeon, or with medications and blood products. Occasionally, postoperative bleeding may require another operation.
Complications during and after pediatric heart surgery can include:
The child is monitored very closely after open heart surgery. Every child’s heals at their own pace. Each day the child is in the hospital, the care team will talk about how the child is doing and help create a care plan to get the child closer to going home.