Atrial Septal Defect Repair
What You Need to Know:
An Atrial Septal Defect Repair (ASD) is surgery to close a hole in the septum (wall) between the upper chambers of your heart. The upper chambers are called the right atrium and the left atrium. An ASD repair is done through open heart surgery.
- You will stay in the hospital for a few days after surgery. You may spend the first one to two nights in the intensive care unit (ICU). You may have several drains and IVs, and you may be on a ventilator after surgery. A ventilator is a machine that gives you oxygen and breathes for you when you cannot breathe well on your own. An endotracheal (ET) tube is put into your mouth or nose and attached to the ventilator. The ET tube may be removed when you are awake and breathing well. You may need a blood transfusion to replace blood that is lost during surgery.
- Your face and body may look swollen right after surgery. The swelling should go down in a few days. You may have pain where the incision was made. You will get medicine to control pain and make you comfortable. It is normal to feel tired at first, and get stronger each day.
- It may take you several weeks to recover from surgery. During this time, you may need someone to help you with laundry, cooking and activities of daily living (ADLs). ADLs include bathing, dressing and grooming. Talk to your healthcare provider if you do not have someone to help you at home. Healthcare providers may be able to come to your home and help you with ADLs. You may not be able to drive for several weeks. You may want to arrange for someone to drive you to appointments and errands during this time.
Preparing For Insertion of An ICD
You may need blood tests, a chest x-ray, an EKG, or an echocardiogram before your surgery. You may need to stay in the hospital the night before surgery to complete these tests. The tests will help your healthcare provider plan for your surgery. They will also make sure you are ready for surgery. You may be able to donate your own blood before surgery. A family member or a friend with the same blood type as you may be able to donate blood for you.
Your healthcare provider may tell you not to eat or drink anything after midnight on the day of your surgery. You will be told what medicines to take or not take on the day of your surgery. You will be given an antibiotic through your IV on the day of surgery. This will help prevent a bacterial infection. Tell the healthcare provider if you have ever had an allergic reaction to an antibiotic.
You will be given general anesthesia to keep you asleep and free from pain during surgery. An IV may be placed in your wrist to monitor your blood pressure. A second IV may be placed in a large vein in your chest or neck to monitor pressures in your heart. Your healthcare provider will make an incision in your chest. Your ribcage will be cut or spread apart to reach your heart. Your heart may be connected to a bypass machine. This machine pumps blood to your body and keeps blood out of your heart during surgery.
Your healthcare provider will make a second incision in your heart. The ASD will be closed with stitches or a patch. The bypass machine will be stopped and blood will flow through your heart again. The incision in your heart will be closed with stitches. Your healthcare provider may place one or more drains in your chest to remove air, blood or fluid. The incision in your chest will be closed with wire and stitches or staples. A bandage will be placed over the incision.
Recovery in the Hospital
Take deep breaths and cough. This will help decrease your risk for a lung infection. Take a deep breath and hold it for as long as you can. Let the air out and then cough strongly. Hold a pillow tightly against your incision when you cough. Deep breaths help open your airway. You may be given an incentive spirometer to help you take deep breaths. Put the plastic piece in your mouth and take a slow, deep breath. Then let the air out and cough. Repeat these steps 10 times every hour.
Get out of bed when your healthcare provider says it is okay. Movement will help prevent blood clots. You may be given exercises to do in bed. Talk to healthcare providers before you get up the first time. They may need to help you stand up safely. When you are able to get up on your own, sit or lie down right away if you feel weak or dizzy. Then press the call light button to let healthcare providers know you need help. You may need to hold a pillow against your incision when you move in and out of bed. This will help decrease pain.
Wait until your healthcare provider says it is okay to eat and drink. You may be given ice chips at first. Then you will get liquids such as water, broth, juice and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft foods easily, you may slowly begin to eat solid foods.
Undergoing open-heart surgery carries the risk of adverse reaction to anesthesia, bleeding and infection in the surgical site. There is also a small risk of developing blood clots, especially in cases where a closure device is used. Most patients are prescribed long-term medications to prevent this episode. Patients also have a higher risk of developing infective endocarditis following this procedure.
The procedure has a high success and low morbidity rate, especially among younger patients. In fact, most survive well into adulthood with little or no complications, and no activity restrictions. However, they need to maintain regular check-up sessions with their physicians to ensure the overall health of their heart.
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