Post-Op

Care of the Incision

  • The stitches will be removed before your child goes home.
  • Some children will have small pieces of tape (steri-strips) covering the top layer of skin. Ten to fourteen days after surgery the steri-strips will begin to dry up and peel off. Allow the steri-strips to fall off on their own.
  • Some children have small incisions from the chest tubes. It is normal to have a small amount of clear yellow or dark bloody drainage from this incision. A dry band-aid or light gauze may be used if there is drainage.
  • Your child may bathe or shower the day after the stitches are removed. It is best not to let your child soak in the tub until the incision is completely healed-about 7-10 days.
  • Do not apply lotion, oil, or cream to the incision until it is completely healed.
  • The incision will fade best if your child avoids sun exposure for several months after surgery. A sunscreen (at least SPF 15) is recommended.

Activity

  • Allow your child to play at his or her own pace.
  • Avoid activities that may cause injury to the chest. (Contact sports, physical education, sledding, bike riding, playing on swings and slides, roughhousing)
  • Avoid activities that require vigorous use of the arms for about 6 weeks after surgery. (crawling, shoveling, lawn mowing, golfing, tennis, bowling, swimming, push-ups/chin-ups)
  • Your child may not lift anything over 5 pounds until 6 weeks after surgery.
  • To avoid pain and tension on the incision, do not lift your child under the arms. Instead, lift your child by supporting their bottom and back.
  • Most children can return to school about 2 weeks after their clinic visit.
  • Do not allow your child to drive for 4 weeks. If your car does not have automatic transmission and power steering, your child should wait 6 weeks to resume driving.

Pain

  • Most children are experiencing mild discomfort by the time they go home.
  • Chest pain is not unusual. Gas pains may seem to be "chest pain" to a child. This is best relieved by walking or rocking.
  • Tylenol (acetaminophen) may be given at the age-appropriate dose and frequency.

Daily Living

  • Your child may have difficulty sleeping after his/her hospitalization.
  • Loss of appetite for 2 to 3 weeks after heart surgery is common.
  • Encourage your child to eat and drink; cold foods are often preferred over hot.
  • To protect your child from colds and illnesses, avoid day care and crowded areas.

Prophylaxis of Bacterial Endocarditis (SBE Precautions)

  • Your child will need to continue to take antibiotics prior to having dental work or certain surgical procedures.
  • A few children will be able to discontinue this practice six months after surgery. Be sure to discuss this with your child's pediatric cardiologist.

Return Appointments

  • Arrange to see you family doctor or pediatrician one week after your child returns home.
  • A follow-up appointment with your child's surgeon and pediatric cardiologist will be arranged for 2 weeks after surgery.

Contact the doctor at 717-531-8674 or toll free at 866-CHG-CARE (244-2273) if your child develops:

  • Cloudy yellow drainage from the incision
  • Increased redness or swelling (bulging) of the incision
  • Fever over 101.5° F by mouth (100.5° F under the arm for infants and young children)
  • Persistent vomiting
  • Increased pain
  • Shortness of breath, breathing difficulties
  • Breastbone popping or clicking

Pediatric Cardiovascular Surgery Office

Phone:  717-531-2050
Toll Free:  866-CHG-CARE (866-244-2273)
Fax:  717-531-2052
Email:  childrensheartgroup@hmc.psu.edu

Providers

Nurses

Medical inpatient treatment, cardiac catheterizations and all surgical procedures are performed at Penn State Hershey Children's Hospital at Penn State Milton S. Hershey Medical Center.

Pre-Op

 

  1. What should I expect during the pre-op visit?
    During the pre-op visit you will meet with the surgeon (Dr. John Myers or Dr. Brian Clark). The surgeon will explain the operation that has been recommended for your child, and you will be asked to sign the consent form for the surgery. You will also meet with the anesthesiologists who will have a second consent form specific for the anesthesia for you to sign. Your child will have a short History and Physical, and you child will need to have blood drawn for his Type and Cross to set aside blood for him for the day of surgery. They will place a pink band on his arm which needs to remain on until surgery. This entire process takes approximately 4 hours.
     
  2. Must my child receive a blood transfusion the day of the surgery?
    The possibility of your child receiving a blood transfusion is dependent on his weight and the type of surgery being performed. Our surgeons will avoid giving a child blood whenever possible. Some families prefer to donate blood for their child. This is called designated donation. There may be an additional charge for this service. There is no medical benefit to donating blood for your child, but if this is something you wish to do, arrangements should be made at the time you schedule surgery. You need to contact Blood Bank at (717) 531-8232 to schedule directed donation.
     

Day of Surgery

 

  1. How will I know how surgery is going?
    Most operations are uneventful. When surgery is nearly completed, Penny Porter or Katrina Thoma  (nurse practitioners) or Warren Smith (social worker) will update you. Our surgeon will see you after surgery and answer any questions. If there would be a significant change in your child’s prognosis, we will notify you immediately. We recommend that you wait in the Ronald McDonald family waiting area outside the PICU on the 7th floor south addition.
     
  2. What will my child look like after surgery?
    Typically there will be some small tubes and wires coming out below the breast bone. The area of the incision will be covered with a sterile dressing. Very often they are sleeping or very groggy the first time you see them after surgery. We will offer you a tour of our PICU area while your child is in surgery, to familiarize you with the layout.
     
  3. Where do I wait during surgery?
    7th floor Ronald McDonald Family Waiting Room
     

Hospitalization

 

  1. Should my child's siblings be part of the hospitalization experience?
    This depends on the age and level of understanding of the siblings. If they appear fearful of what's going to happen, a visit will help to alleviate their fears. This is especially important if they have recently had the experience of a family member going to the hospital and not coming home.
     
  2. May I stay with my child during his hospitalization?
    We encourage you to stay with you child as much as possible. While your child is in the Pediatric Intensive Care Unit (PICU), you may visit at the bedside as much as you like, but there is no place for you to sleep in the unit. We ask that visitors are limited to 2 at the bedside at a time. There will be times that you are asked to step out for short periods of time. You are also encouraged to call the unit for updates if you cannot be there. We will only give information to parents on the phone. When your child is moved to the step-down area (our intermediate unit), most rooms have space for one parent to sleep in the room with the child.
     

Post-Op

 

  1. My child had open-heart surgery and had his sternum (breastbone) closed with wire. Will he set off a metal detector?
    This question goes through many parents' minds. The answer is no, if he sets off the metal detector at the airport, check his pockets for change, etc.
     
  2. What happens to these wires?
    They stay there and the bone grows around them. They are made of stainless steel and do not rust.
     
  3. What will my child's scar look like with time?
    Every person's body scars differently. Most scars fade to a thin white line with time. Scar tissue is more sensitive to sunlight and should be protected from sunlight for the first year after surgery. It's recommended keeping it covered with a shirt or thick stripe of SPF 30 or higher sunscreen.
     
  4. Should I put Vitamin E on my child’s incision to help it heal?
    We recommend keeping the incision clean and dry till it is healed and the scab is off (approximately 2 weeks). After this, it is personal preference.
     
  5. What can I expect my child to act like when he comes home from the hospital?
    This is very variable from child to child and depends on the age of the child. Infants maybe fussy and sleep patterns may change for the first week after discharge. Toddlers are frequently "clingy" while in the hospital but this improves quickly after discharge. Older children and teenagers will be more tired than usual, perhaps even taking naps the first week after discharge. Most infants and small children's behavior returns to normal in approximately one week after surgery, older children and teenagers take about 2 – 4 weeks for their energy level to return to baseline.
     
  6. What will follow-up be like after my child is discharged?
    The routine is to return 2 weeks after discharge. After this visit, follow-up will be by the pediatric cardiologists and varies in frequency depending on your child's diagnosis and progress.