This surgical procedure is done to correct an atrial septal defect (ASD), and it is performed as a open-heart surgery.  

Pre-Operative Details:

Your surgeon will give specific instructions and details before the surgery, including risks (i.e. bleeding, infection, adverse reaction to anesthesia, etc.).  Please make sure to contact your insurance company for coverage.  Also, it is important that the child is free from infection up 6 weeks prior to surgery, including dental infections.  Please make sure immunization records are made available to your surgeon or his nurse.  You will also meet with the anesthesiologist prior to the surgery to go over your medical history.  Please do not eat after midnight the night before your surgery.  On the day of surgery, you will arrive at the hospital, get registered, and get changed into a hospital gown.  A nurse will then review your chart to make sure there are no problems and then get all the paperwork in order for surgery.  The anesthesiologist will then start an IV and you will be taken to the operating room, where the surgeon will verify your name and procedure before any medication is given.  Once you are under anesthesia, surgery will begin.

Operative Details:

Before an incision is made, a cardiologist will do a transesophageal echocardiogram to provide the surgeon a way of looking at the structure of the heart during the surgery.  The incision will then be made in the breastbone/sternum to access the heart.  The patient is then placed on cardiopulmonary bypass, a device used to provide oxygenated blood to the body bypassing the heart and lungs so that the surgeon can operate.  An incision will be made in either the right atrium to access the defect.  Rather than using a patch, the surgeon directly closes the defect using sutures.  The heart is closed with sutures and the cardiopulmonary bypass machine is removed.  Pacing wires will then be placed temporarily on the heart as a safety measure for heart rhythm abnormalities after the operation.  The patient will also have chest tubes placed to collect any residual blood or fluid left in the chest after the surgery.  The skin is then closed with stitches or staples.

Post-Operative Details:

After the surgery, you will be taken to the intensive care unit and will be monitored for heart and lung changes.  You will likely experience pain and will given pain medication appropriately.  You will also have a breathing tube and respirator for the first few hours after surgery, and will not be able to speak until it is removed.  It is important to keep the incision areas clean and dry.  The length of your hospital stay depends on how quickly you are able to recover and perform some physical activity.  If you experience fevers, severe pain, redness/swelling/warmth where the incisions were made, or drainage from the incisions, please let your doctor know immediately.  Your surgeon will give specific instructions about recovery time.