Surgery for Congenital Heart Disease in Adults

Sometimes, heart surgery is needed to treat a congenital heart defect. Surgery may be needed to:

• Fix a hole in the heart, such as a ventricular septal defect or an atrial septal defect
• Close a blood vessel that didn’t close after birth (such as patent ductus arteriosus)
• Repair complex complex heart or blood vessel problems
• Fix or replace a valve
• Open blood vessels that are too narrow

How do I prepare for surgery?

Before surgery, you’ll have counseling and some tests. These may include:

• Electrocardiogram (EKG or ECG)
• Echocardiogram
• Chest X-ray
• Blood work

The surgeon’s office will tell you when to arrive and share any special instructions. Most of the time, you won’t be able to eat or drink for several hours before surgery. Your care team will give you specific instructions.

How long the surgery takes and how long you stay in the hospital depend on your heart condition and the type of surgery you have.

What happens in the operating room?

A team of doctors, nurses and technicians will care for you during the surgery. This team includes a heart surgeon and an anesthesiologist. The surgeon does the operation. The anesthesiologist gives you medication to keep you asleep and watches your vital signs.

For many open-heart surgeries, the team uses a heart-lung machine, also called a cardiopulmonary bypass machine. The machine takes over for the heart and lungs during surgery. It adds oxygen to your blood and pumps it through your body while the surgeon repairs the heart.

While the machine is working, medication is used to stop the heart so the surgeon can do the repair. When the surgery is finished, the heart is restarted, and the heart-lung machine is turned off and removed.

Some surgeries on the blood vessels near the heart don’t need a heart-lung machine.

Will I need a blood transfusion?

Some heart surgeries require blood transfusions during heart operations, but not all patients need them. Donated blood is carefully tested to make sure it matches your blood type and is safe.

Sometimes, blood is in short supply. In some cases, patients may be able to donate blood their own blood ahead of time, depending on the hospital’s policies.

What happens in the intensive care unit?

After surgery, you will go to the intensive care unit (ICU). Specially trained doctors, nurses and technicians will care for you around the clock.

You may have blood tests, heart tests and chest X-rays to check how your heart, lungs and other organs are working. You may also receive IV medications to support your heart, control blood pressure or help your body get rid of extra fluid.

You will be kept as comfortable as possible with pain medications and medications that help you rest.

While you’re in the ICU, you may have some of these monitors and tubes to help your care team watch over your recovery:

• Central venous line: A catheter is placed in a large vein to give medications and fluids and to monitor pressure in your veins and heart.
• Arterial line (art line): A catheter is placed in an artery to continuously measure blood pressure and allow frequent blood tests.
• Arterial blood gas (ABG): This blood test shows how well your lungs are working and how much oxygen and carbon dioxide are in your blood.
• Oxygen saturation (sat monitor): A small clip is placed on the finger or toe to check oxygen levels in your blood.
• Ventilator (breathing machine): This machine helps you breathe until you can breathe on your own.
• Continuous positive airway pressure (CPAP): This device is worn over the nose or nose and mouth to deliver oxygen under gentle pressure to keep the lungs open.
• Nasal cannula: Small tubes are placed in the nose to deliver extra oxygen.
• Chest tube: A tube that drains fluid and air from around the heart or lungs after surgery.
• Foley catheter: A tube that drains urine from the bladder so the care team can watch kidney function.
• Pacing wires: Thin wires attached to the heart to control the heart’s rhythm if needed.

Will I need further hospital care?

After you leave the ICU, you’ll move to a part of the hospital with less intensive care. Your heart rate and rhythm may still be monitored. You’ll be encouraged to cough and take deep breaths to help prevent lung problems such as infection or partial lung collapse. Gradually increasing activity, such as walking, can also help you recover faster.

Eating well is important for healing. Some people may need low-salt foods to help prevent fluid buildup.

A mild fever can be common in the first few days after surgery. If it continues or gets worse, your healthcare team may check for infection or other causes.

You may need pain medication at first, but pain usually improves over time, though some discomfort may last for several weeks.

When your doctors feel you’re well enough, you’ll be able to go home. You may be given medications to take at home. Make sure you understand how to take them before leaving the hospital.

What Happens After Heart Surgery? (PDF)

What Can I Expect When I Go Home After Heart Surgery? (PDF)