Patients referred for surgical treatment of their congenital heart disease have undergone a thorough cardiac evaluation by one of our pediatric cardiologist, here at the Children's Heart Group, or from one of our outside referring pediatric cardiologists. These evaluations include a complete physical examination with particular attention to the cardiovascular system, an electrocardiogram and an echocardiogram (ultrasound of the heart). Some patients require additional evaluation including cardiac catheterization and special scans such as a CT scan or MRI. Once the preoperative evaluation is completed it is reviewed at our weekly conference where our entire group of pediatric cardiologists and pediatric cardiac surgeon review the information and determine what is the best surgical treatment for your child. Following this conference, an appointment is made for the patient and his/her family to meet with one of the surgeons (Dr. John Myers or Dr. Brian Clark) in his office to discuss the recommended surgery. Patients are evaluated by our pediatric cardiac anesthesiologists and an operative date is arranged. You and your child will also have the opportunity to meet with Penny Porter, R.N., C.R.N.P. and Katrina Thoma, C.R.N.P./P.N.P, RN, MSN, our Pediatric Cardiac Surgery Nurse Practitioners, and Warren Smith, MACS, our dedicated social worker. A tour of our facility is encouraged to familiarize you and your child with the Penn State Children's Hospital before the date of surgery.
Pediatric Cardiovascular Surgery Office
Toll Free: 866-CHG-CARE (866-244-2273)
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.
- 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.
- 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
- 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.
- 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.
- Where do I wait during surgery?
7th floor Ronald McDonald Family Waiting Room
- 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.
- 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.
- 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.
- What happens to these wires?
They stay there and the bone grows around them. They are made of stainless steel and do not rust.
- 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.
- 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.
- 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.
- 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.