Discharge Instructions: After Your Child’s Heart Surgery

Your child just had surgery to treat a heart problem. This surgery needed a cut (incision) down the chest or breastbone (sternum) or between the ribs. This sheet gives you general guidelines to care for your child at home after heart surgery. Your child’s doctor and nursing staff can answer questions and give you more information.

Caring for your child’s chest and incision

• Steri strips (white tape strips over the incision) should be removed 5 days after surgery.
• Gently clean the incision daily with soap and water.  No lotions or ointments on the incision unless otherwise instructed by your physician.
• Dry the incision well by patting with a clean soft towel.
• Tub baths and showers may be taken 5 days after surgery.  It is ok if water flows over the incision but, do not submerge your child in water for at least 2 weeks after surgery.
• Keep the incision clean and dry.
• Check the incision site every day for redness, drainage, swelling, or separation of the skin. Monitor your child for pain. Itching is normal, but do not let your child scratch the incision. Call the doctor right away if you notice any of the signs of infection.
• Keep your child in loose-fitting clothing to prevent rubbing against the incision.

Age Specific Instructions

Infants

• Don’t lift your child under the arms for at least 4 weeks after surgery. Lifting stretches the chest and can cause pain at the incision site. Instead, scoop child up while supporting child’s bottom & back.
• No daycare until after the first follow-up visit with cardiologist
• Make sure all family members and visitors wash their hands prior to coming in contact with your child
• No contact with family members or visitors with flu-like or cold symptoms

Children

• No daycare/school or until after the first follow-up visit with cardiologist
• No swimming in pools, oceans or lakes for 4 weeks
• No gym class, playground or bike riding for 6 weeks
• No lifting items greater than 5 pounds for 6 weeks
• Do not lift your child using his/her underarms for 4 weeks. Instead, scoop child up while supporting their bottom & back.

Young Adults

• No school or work until after the first follow-up visit with cardiologist
• If your child is a teenager with a driver’s license, don’t let him or her to drive for at least 4 weeks.
• No gym class, rough play or contact sports for a minimum of 8 weeks. Beyond 8 weeks this is under the direction of your child’s Cardiologist. Examples of such activities include: Baseball, Basketball, Football, Soccer, Hockey, Swimming, Tennis & Bike Riding
• No lifting items greater than 10 pounds including carrying backpacks for 6 weeks

Other home-care Instructions

• Give your child over-the-counter or prescribed pain medicines as directed by your child’s healthcare provider in order to prevent discomfort while recovering at home.
• Most children return to a normal diet while they are still in the hospital. Infants or newborns recovering from heart surgery may have a harder time with feeding. Give your child breastmilk or formula as directed by your child’s healthcare provider.
• Protect your child from infections during healing. You should wash your hands often with soap and water. So should anyone else who takes care of your child. Limit contact with visitors and stay away from crowded public areas. If people in the household are ill, limit their contact with your child.
• Your child will need to rest for 2 weeks at home before going back to normal physical activity or returning full-time to school. It’s important not to push your child until he or she is ready to return to a normal routine. But getting up and walking several times during the day is good for your child’s recovery.
• Your child should not see a dentist or have any other surgery for 3 months after heart surgery
• Between 3 and 6 months after surgery antibiotics should be taken before dental procedures and before any scheduled or emergency procedures. Antibiotics are used to prevent an infection called bacterial endocarditis. This is referred to as SBE prophylaxis. Please ask your Cardiologist about The American Heart Association guidelines for SBE prophylaxis.

Immunizations

• Infants and children should follow the current AAP immunization schedule. Exception MMR or other live viruses should be delayed for 6 weeks after surgery

Follow-up

An appointment with your child’s cardiologist will be scheduled within 1-2 weeks of discharge. Your child may need follow-up tests to check how well your child’s heart is working.

When to call the healthcare provider

Call your child's healthcare provider right away if your child has:

• Increased pain, redness, draining, swelling, or bleeding at the incision site

• Fever (see Fever and children, below)

• Trouble feeding/eating, poor appetite, or weight loss 

• Shortness of breath or difficulty breathing

• Flaring of the nostrils

• Color changes (gray, pale or blue) of the skin, lips or fingernails

• Cough that won’t go away

• Increased tiredness or irritability

• Prolonged nausea or vomiting

• Irregular heartbeat

• No noticeable improvement or you don't think your child is getting better