Heart Surgery

Excellent surgery is the cornerstone of treatment for most babies, kids, and teens with serious heart disease. The cardiac surgeons in our state-of-the-art Nemours Cardiac Center have the training and the talent required to provide first-rate surgical care to our patients of all ages. Over the years, there’s been remarkable progress in the surgical management of heart disease in the young – and our surgeons are right there at the forefront, contributing to those incredible ongoing advances. Now, reconstructive heart surgery can help virtually all patients with structural heart disease, even the most complicated.

At the Nemours Cardiac Center, located in the world-renowned Nemours/Alfred I. duPont Hospital for Children (AIDHC), children born with virtually any heart defect or condition – even those only hours old – can be swiftly diagnosed and treated right when it matters the most.

Who we are

Our experience and skills in caring for children with heart disease is wide-ranging and comprehensive. We provide care not only for congenital heart defects , but also for diseases of the heart, lungs, and blood vessels inside the chest that develop later in infancy or childhood.

Our Cardiac Center features its very own operating room, used exclusively for pediatric heart surgery and staffed with a highly skilled team of professionals that includes:

• pediatric cardiologists (children’s heart doctors)
• pediatric cardiothoracic surgeons (who specialize in operating on children’s hearts and chests)
• pediatric cardiac nurses
• pediatric anesthesiologists (who work exclusively in our Cardiac Center)

Surgery at the Nemours Cardiac Center is performed by board-certified cardiac surgeons with expertise in all aspects of heart surgery, including:

• neonatal surgery (operations on newborns)
• heart valve repairs
• aortic surgery (of the large blood vessel coming from the heart)
• thoracic surgery (chest surgery)
• mechanical circulatory support (bypass)
• cardiac transplantation (heart transplant)
• single-ventricle palliation (temporary improvement in the function of the heart in babies born with one working ventricle instead of two; includes defects like hypoplastic left heart syndrome – when the left side of the heart is underdeveloped)

Treatments

For children with serious heart disease, surgery may be the best treatment option. Heart surgery is performed to repair and reorganize abnormal structures in the heart so that the heart muscle isn’t overburdened. And early diagnosis and repair of a child's heart defect avoids years of often-damaging abnormal circulation and allows the heart to function normally again as quickly as possible.

But many children’s heart problems can be treated without any surgical incisions, through a procedure called “interventional (or therapeutic) cardiac catheterization” (in which a thin plastic tube is inserted into an artery or vein in the groin and guided into the heart). This is a procedure we usually perform in our new digital state-of-the-art catheterization suite.

In some complex cases, though, members of our team work together to perform both open-heart surgery and interventional catheterization procedures in the same setting. By offering this kind of combined treatment option (typically called a “hybrid procedure”) we’re improving the outlook for scores of children – all with less discomfort, fast recovery time, and shorter hospital stays. And we’re proud to be one of only a mere handful of centers in the United States where these combo treatment capabilities are available.

Whenever possible, our surgeons repair abnormalities in the very young, which allows the newly constructed regions of the heart and blood vessels to grow as the child grows. This approach, along with the combined catheter and surgical procedures, has allowed us to minimize the number of operations our young patients need – and give them the very best chance of leading a happy, active, and long life.

Heart Transplants

Although most patients with heart disease can be successfully treated with medicine or surgery, for some, heart transplantation may be the answer. A heart transplant is an operation that replaces a diseased heart with a healthy heart from another person. Heart transplantation is recommended for children who would not be able to live without having their heart replaced.  Illnesses that can affect the heart in this way include complex congenital (from birth) heart defects and cardiomyopathy (when the heart muscle is inflamed and doesn’t work as well as it should). 

The pediatric Heart Transplant Program at AIDHC performed the first heart transplant in the state of Delaware. Our specialists from cardiology and cardiac surgery lead a team of advanced practice nurses, physician assistants, pharmacists, physical and occupational therapists, dietitians (nutritionists), social workers, and child life specialists to provide transplant care for children and their families before, during, and after the surgery.  

Nemours also has an active Mechanical Circulatory Support Program that provides Extracorporeal Membrane Oxygenation (or ECMO) – a system that temporarily acts as a patient’s heart and lungs. We also offer Ventricular Assist Devices (VAD) – mechanical pumps that take over the work of the damaged chamber (ventricle) of the heart. This includes the Berlin Heart (a pump device that comes in various sizes to accommodate children). These assistive devices are used for patients who require “artificial” heart support while waiting for a heart transplant or for their own heart problems to improve.

At Nemours, our team works together to provide expert, comprehensive care for children with end-stage heart disease. Learn more about our Transplant Programs.

Anesthesiology

Our Cardiac Center has its very own pediatric anesthesiologists with the experience and skills required to provide specialized anesthesia for children with heart problems, from the minor to the very complex. Our anesthesiologists provide anesthesia or deep sedation for surgery, cardiac catheterization, and other tests that may be painful or uncomfortable for your child.

Separation from parents is one of the most stressful aspects of hospitalization – for older babies up through adolescence. That’s why we give medication, before a procedure, that produces a relaxed feeling so your child won’t feel so scared or worried. Soon after reaching the location where the procedures are performed your child will then get further sedation or general anesthesia, which makes for an anxiety and pain-free experience during the procedure. In the operating room, we give modern anesthetic medications that have little effect on how the body’s organs work and provide a safe and smooth transition to pain control after the procedure.

When it’s appropriate, epidural medications (given as an injection in the lower back) are used to ease pain after chest surgery. For catheterization or other outpatient procedures, your child will receive sedation or anesthetic medicines that provide a quick, more comfortable “wake up” and fewer side effects. Our anesthesiologists also “go on the road” to accompany your child to other parts of the hospital to provide sedation for diagnostic tests such as MRI or CT scan. 

Families encounter many new experiences and people within the hospital. Because the cardiac anesthesiologists at the Cardiac Center often care for patients more than once, we get to know your child and your family – and we’re able to determine which medications and strategies work best for your child’s individual needs. We find that parents are often reassured to see a trusted familiar face as their child makes a trip to the operating room or other hospital location out of their watchful sight.

Critical Care

Infants and children who have heart surgery usually spend their first night in the Cardiac Intensive Care Unit (CICU). There may also be times when the function of the heart, lungs, or kidneys are significantly impaired and your child will need to stay in the CICU – patients with complicated problems may stay there for extended periods of time.

In these cases, your child will receive specialized care in the CICU, where our doctors, nurses, respiratory therapists, pharmacists, and other health professionals are equipped with sophisticated technology to monitor your child and adjust treatment on a moment-to-moment basis to achieve the best outcome possible.

Every phase of treatment and hospitalization is intended to keep your with your child – and to take some of the anxiety and fear out of evaluation, treatment, and rehabilitation. We designed our center to act as a "home away from home" for our patients and parents throughout the hospitalization. Patient rooms are furnished with beds for parents and child. Parents continue to occupy the room during their child's Intensive Care Unit stay, allowing them to be comfortable as well as available to the child day and night. Cardiac Center rooms also feature a private bath, telephone, TV and VCR.