Ongoing care after heart surgery

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Learn about ongoing care for children with congenital heart disease. Frequency of evaluation, adult care, and non-cardiac surgery are discussed.

Key points

  • Children who have been treated for heart conditions must be regularly monitored as the heart can change over time.
  • Your child's cardiologist will tell you how frequent follow-up visits should be.
  • Your child needs regular dental care to reduce the risk of infective endocarditis.
  • If your child needs surgery that is unrelated to their heart condition, all the health care professionals involved must know about their congenital heart disease as they face a slightly higher risk from surgery.

This page explains what kind of care your child will need after they have been treated for a heart condition.

Will your child need to see a cardiologist for the rest of their life?

It is very likely that your child will need to have regular follow-up for the rest of their life. How involved the care needs to be depends on the type of condition they have and how successful treatment was. It's important to have your child regularly monitored, even if treatment was very successful and your child is feeling healthy, because the heart can change over time. Also, because treatment for paediatric heart conditions is still fairly new, doctors need to keep a close eye on the potential long-term effects.

If your child is young, they will see their paediatric cardiologist regularly. When they get older, they will need adult care. Your child's cardiologist will be able to tell you what to expect in terms of visits and how to transition to adult cardiology care when the time comes.

How often will your child need to be evaluated?

If it was a simple condition and treatment was effective, for example, your child may need just infrequent visits to a cardiologist, either the one who initially provided treatment or a cardiologist in your community. Your child's cardiologist will be able to tell you what to expect. A more high-risk defect will need more regular visits to the cardiologist.

What kind of care do adults with congenital heart disease need?

Adults (those over 18) who were diagnosed later in life with congenital heart disease and children diagnosed early who are now adults will need specialized, long-term care. These people are commonly referred to, in the medical world, as adults with congenital heart disease. They have unique needs that are best dealt with not in standard cardiology practices but specialized clinics that are continually developing expertise in how to deal with these individuals.

How often do adults need to be evaluated?

Generally speaking, about half of adult congenital heart disease patients will need to be seen every 12 to 24 months by a cardiologist with specific congenital heart disease experience at a regional congenital heart disease centre because of the risk of serious complications.

Should your child still see a family doctor?

Yes, your child should continue to see your family doctor or paediatrician for typical ailments and to ensure overall health by way of regular check-ups. It's important to follow a proper care routine and see the doctor regularly. Be sure they know the details of your child's heart condition.

During this time, your child will likely still continue to regularly see the paediatric cardiologist or, if older, a cardiologist who specializes in adults with congenital heart disease.

What about seeing other specialists?

As your child gets older and has other issues to deal with, they should consult the appropriate health care professionals, such as a dermatologist for concerns about acne. Again, you or your child should be sure to alert them to your child's heart condition.

What about the dentist?

Dental problems such as cavities, abscesses, or periodontal disease can increase the risk of infective endocarditis (inflammation of the heart caused by infection). Your child needs regular dental care to reduce the risk of these problems.

Antibiotics may be recommended before certain dental procedures, depending on your child's diagnosis.

What about non-cardiac surgery?

If your child needs surgery at some point for a condition unrelated to their heart condition, it's critical that all the health care professionals involved are aware of his congenital heart disease. Generally speaking, these children face a slightly higher risk from surgery. Particular care needs to be taken with children with cyanosis, arrhythmias, and pulmonary hypertension. The main concern is unstable blood pressure.

Your child's cardiologist is in the best position to speak to the surgeon and anaesthesiologist and identify any potential adverse effects from the surgery. Having this information on hand will enable the treating physician to decide whether surgery is the best approach, and if so, how any potential risks can be minimized. The same is true for surgery that is not medically necessary but that the patient would like to have (elective surgery). In some cases, certain drugs your child may be taking may need to be discontinued until after surgery. These drugs include blood thinners and furosemide.

Last updated: January 15th 2010