After Surgery

After pediatric heart surgery, medical equipment is used to monitor and care for your child during their hospitalization. Though this equipment can be overwhelming, these medical devices are important during your child’s recovery process. Below are some of the common medical devices we use and what function they serve. Please be aware that you may see some of these devices before or after your child’s surgery, as well as during their hospital stay. If you have a specific question about any of the equipment being used, please ask your bedside nurse or doctor for clarification.

Monitoring Equipment

In our center, patient’s vital signs are monitored by many state-of-the-art bedside systems. This system monitors heart rate and rhythm, respiratory rate, oxygen in the blood, and blood pressure.

Intravenous (IV) Lines

Peripheral Intravenous Lines (PIVs) – is a soft catheter placed in a small vein through which intravenous fluid and medications can be given. A PIV may be placed upon admission into the hospital. Pain-relieving measures are available, and may be applied to your child’s skin prior to placing the peripheral line. Your child will likely have a PIV in place throughout their hospitalization.

Central Lines

A soft catheter placed (usually during surgery) in a vessel or a chamber of the heart. It is used to monitor heart pressures and to administer IV fluids, medications and nutrition. The insertion site can be in the neck, chest, groin or umbilicus.

IV Infusion Pumps and Drip medications

Infusion Pumps will likely be used to infuse medications to support the heart until it can recover from surgery. Continuous IV medications are given to manage pain and anxiety after surgery. IV fluids providing nutrition will be given until your child can be fed.

Ventilator

A ventilator is a machine that supports your child's while they are sedated. This machine is connected to the endotracheal tube.

Nasogastric or Orogastric Tube (NG or OG Tube)

These are tubes placed to provide access to your child's stomach. They can be used to provide nutrition or to drain the stomach.

Chest Tubes Drainage

These are small tubes placed around the heart or lungs to prevent accumulation of fluids after surgery. These drains are connected to a collection device to measure the drained fluid. They are typically removed when drainage subsides.

External Pacing Wires

Sometimes after open heart surgery, the heart’s natural beauty mechanism impaired. This is usually a temporary problem, but rarely, can be permanent. External pacing wires are small wires placed in the heart muscle through which electrical impulses can travel to the heart. These wires exit the chest wall and can be attached to a pulse generator. They are typically removed with minimal discomfort.

Pacemaker

This is a small box that generates an electrical impulse sent to the heart muscle to stimulate contraction.

Foley Catheter

This is a soft tube placed in the bladder to drain urine. An important indicator of heart function, urine output is monitored closely.  This catheter stays in place for as long as needed while in the Heart Center.

Monitoring

While in intensive care, your child will be observed closely. Staff may take frequent blood tests, x-rays and echocardiograms to evaluate heart function. Bedside nurses will also monitor your child’s pain level, and different types of medications may be administered to help alleviate any discomfort.

Swelling

After surgery, patients may have swelling from the bypass pump used during the operation.  Most swelling usually occurs between the first 24-48 hours post-surgery.  Your child’s body will eventually reabsorb the excess water from the swelling and will flush it out through urination. Once all the excess fluid is excreted, the body will return to its normal size.

Surgical Incisions

There are two types of incisions that can be made in the operating room: Sternotomy or a thoracotomy. The incision used depends on the type of surgery needed.

sternotomy is an incision made on the front of the chest over the sternum. The sternum is separated and opened allowing surgeons access to the heart. Immediately after the operation, sternal wires and skin sutures are used to close the sternum and incision. Sometimes it is necessary to leave the sternum open for a brief period (usually 1-3 days) to allow time for swelling to decrease. If the sternum is left open, a dressing is sewn to the edges of the skin to cover the heart. A clear dressing is placed over this to cover the chest wall, and will remain there until the chest is closed. If the sternum is closed, a sticky tape called Steri-Strips and/or skin glue called Collodion is applied over the incision to keep it clean while it heals. The skin glue wears off over a two-week period, at which time the skin should be completely healed.

thoracotomy is an incision made on the patient’s side that usually begins just below the armpit and extends around to the back. After surgery, the incision is closed and covered with Steri-Strips and Collodion.

Activity

Once your child is hemodynamically stabilized (blood pressure and heart functions are better), it is important that they become more active. In fact, getting out of bed and walking as soon as possible should be a priority. Activity helps keep the lungs clear of fluid and mucous, increases bowel activity, strengthens muscles, decreases stiffness and is good for emotional well-being.