What is the Surgical Repair of Patent Ductus Arteriosus

Surgical repair of patent ductus arteriosus is a procedure to close the patent ductus arteriosus. This is done by making a large incision in the chest and closing the patent ductus arteriosus with stitches (sutures) or a clip.

The ductus arteriosus is a blood vessel in the heart that usually closes after birth. When the ductus arteriosus does not close soon after birth, it is called an open (patent) ductus arteriosus.

Tell a health care provider about:

• Any allergies your child has.
• All medicines your child is taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems your child or family members have had with the use of anesthetics medicine.
• Any blood disorders your child has.
• Any surgeries your child has had.
• Any other medical conditions your child has.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Severe bleeding (hemorrhage).
• Allergic reactions to medicines or dyes.
• Damage to other structures or organs, such as a nerve or a heart chamber or valve.
• Failure to close the patent ductus arteriosus completely.
• Collapsed lung.
• Blood clot.
• Stroke.

What happens before the procedure?

Staying hydrated

Follow instructions from your child’s health care provider about hydration, which may include:

• Up to 2 hours before the procedure – your child may continue to drink clear liquids, such as water or clear fruit juice.

Eating and drinking restrictions

Follow instructions from your child’s health care provider about eating and drinking, which may include:

• 8 hours before the procedure – have your child stop eating foods.
• 6 hours before the procedure – have your child stop drinking formula or milk.
• 4 hours before the procedure – stop giving your child breast milk.
• 2 hours before the procedure – have your child stop drinking clear liquids.

Medicines

• If your child is taking medicines, follow instructions from your child’s health care provider about changing or stopping the medicines before your child’s procedure.

What happens during the procedure?

• To lower your child’s risk of infection:
  • Your child’s health care team will wash or sanitize their hands.
  • Your child’s skin will be washed with soap.
• An IV will be inserted into one of your child’s veins.
• Your child will be given:
  • A medicine to help him or her relax (sedative).
  • A medicine to make him or her fall asleep (general anesthetic).
• A tube will be placed down your child’s throat to help with breathing.
• An incision will be made in the side or the front of your child’s chest.
• The patent ductus arteriosus will be located and closed with sutures or with a clip.
• A tube (chest tube) may be placed between the ribs to drain fluid from the surgical area.
• A bandage (dressing) will be placed over the incision.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your child’s blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines he or she was given have worn off.
• Your child may experience temporary pain and discomfort. This is normal. Your child will be given medicines to relieve pain or to help him or her relax.
• Your child may have an echocardiogram to check the success of the procedure. This test produces images of the heart using sound waves.

Summary

• Surgical repair of patent ductus arteriosus is a procedure to close the patent ductus arteriosus. This is done by making a large incision in the chest and closing the patent ductus arteriosus with stitches (sutures) or a clip.
• Follow instructions from your child’s health care provider about eating and drinking before surgery. You may also have to stop giving certain medicines before surgery.
• Your child may experience temporary pain and discomfort after the procedure. This is normal. Your child will be given medicines to relieve pain or to help him or her relax.

Surgical Repair of Patent Ductus Arteriosus, Pediatric, Care After

Here is the information about how to care for your child after his or her procedure. Your child’s health care provider may also give you more specific instructions. If you have problems or questions, contact your child’s health care provider.

What can I expect after the procedure?

After the procedure, it is common for your child to have:

• Chest pain and discomfort. This may last for a few weeks.

Follow these instructions at home:

Medicines

• Give your child over-the-counter and prescription medicines only as told by his or her health care provider.
• If your child was prescribed an antibiotic medicine, give it to him or her exactly as told by your child’s health care provider. Do not stop giving the antibiotic to your child even if he or she starts to feel better.
• Do not give your child aspirin because of the association with Reye syndrome.

Incision care

• Follow instructions from your health care provider about how to take care of your child’s incision. Make sure you:
  • Wash your hands with soap and water before you change your child’s bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your child’s dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your child’s incision area every day for signs of infection. Check for:
  • Redness, swelling, or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.
• Keep your child’s dressing clean and dry. If it gets wet, change it right away.

Activity

• Limit your child’s activity as directed by your child’s health care provider.
• If your child’s incision is in the front of the chest:
  • Do not lift or pull your child by the arms.
  • Do not allow your child to push or pull anything, lift heavy objects, or put his or her arms over his or her head.
• Return your child to school or day care as directed by his or her health care provider.

General instructions

• Tell your child’s health care providers, including the dentist, that your child has had heart surgery. Do this every time your child needs medical care. Your child may need to take medicines to prevent infection.
• Do not allow your child to soak in water, such as by sitting in a bathtub or swimming, until his or her health care provider approves. Your child may shower or receive sponge baths.
• Feed your child as directed by his or her health care provider.
• Do not let your child cry for a long period of time, for 3–4 weeks after the procedure. Calm your child if he or she begins to cry.
• Keep all follow-up visits as told by your child’s health care provider. This is important.

Contact a health care provider if:

• Your child seems to feel more pain at the incision site.
• There is fluid or blood coming from the incision.
• Your child’s incision feels warm to the touch.
• There is pus or a bad smell coming from your child’s incision.
• Your child has a fever.

Get help right away if:

• Your child who is younger than 3 months has a fever of 100°F (38°C) or higher.
• Your child is vomiting.
• Your child has abdominal pain.
• Your child has cool feet or legs.
• Your child has chest pain.
• Your child has trouble breathing.
• Your child cannot stop coughing.
• Your child is not getting better.

Summary

• After the procedure, it is common for your child to have chest pain and discomfort. This may last for a few weeks.
• If your child’s incision is in the front of the chest, do not lift or pull him or her by the arms. Do not allow your child to push or pull anything, lift heavy objects, or put his or her arms over his or her head.
• Tell your child’s health care providers, including the dentist, that your child has had heart surgery.