Children's Early Recovery Tips After Congenital Heart Surgery

1. Follow Medication Instructions Carefully

Before discharge, your pharmacist will provide a detailed medication plan. Each child's prescription varies based on their surgery and recovery status. It's vital to follow the dosage and timing exactly as instructed by your doctor or nurse. Common medications include digoxin, furosemide, spironolactone, enalapril, captopril, potassium supplements, prednisone, indomethacin, sildenafil, bosentan, aspirin, and warfarin.

For example, digoxin must be taken every 12 hours, and you should check the child's pulse before each dose. If the heart rate is too slow, skip the dose. Also, avoid calcium supplements while taking digoxin. Captopril should be taken every 8 hours. Enalapril or captopril should not be taken simultaneously with diuretics like furosemide to prevent low blood pressure. Bosentan requires regular liver function monitoring, and warfarin users must track their blood clotting levels. Always follow up with your doctor if medication adjustments are needed.

2. Dietary Guidelines for Recovery

Fluid and Salt Restrictions

In the first month after surgery, maintain a low-salt, low-fat, and fluid-restricted diet. Too much liquid can strain the heart and slow recovery. Follow the fluid intake guidelines provided at discharge.

Recommended Foods

Older children can gradually return to a normal diet but should avoid fatty foods. Lean proteins like chicken or eggs, fresh vegetables, and fruits are ideal. Avoid overfeeding to prevent discomfort and additional stress on the heart. Avoid fatty broths such as bone or fish soup.

3. Proper Wound Care

The surgical wound should be kept clean and dry. Visit a clinic or hospital every 2–3 days for dressing changes until the wound heals. Sutures are typically removed 10–14 days after drain removal. Wait one week after suture removal before washing the wound. Once the scab has fallen off and the area is dry, you can begin gentle bathing.

4. Scar Management with Silicone Sheets

Begin using silicone scar sheets one week after suture removal, once the child can bathe. Apply the sheet directly to the healed wound for 5 hours on the first day. Monitor for any allergic reactions like redness or swelling. If no reaction occurs, increase wear time by 2–3 hours daily until reaching 15–20 hours per day. Clean the sheet with water and air dry it for reuse. Replace the sheet every 30 days and continue for several months for best results.

5. Monitor for Warning Signs

In addition to checking the pulse before each digoxin dose, watch for symptoms like persistent fever, vomiting, refusal to eat, irritability, or abdominal pain in older children. These could signal pericardial effusion, a common complication after heart surgery. If these signs appear, contact your doctor immediately. Mild to moderate effusions often resolve with medication and diet changes, but severe cases may require urgent drainage.

6. Schedule Regular Follow-Up Appointments

Follow-up visits are usually scheduled at 1, 3, 6 months, and 1 year post-surgery. Your surgeon may adjust this schedule based on your child's condition. These visits are essential for monitoring heart function and ensuring a smooth recovery.

Conclusion

Every child's recovery journey is unique, depending on the type of congenital heart defect and surgical approach. While this guide offers general advice, always follow your medical team's specific instructions. With proper care and vigilance, your child can make a full and healthy recovery after heart surgery.