Double-outlet right ventricle surgery is a procedure to repair a heart defect that makes it hard for your child’s heart to pump oxygen-rich blood to the body. This heart defect is called double-outlet right ventricle. It occurs when the blood vessel that carries blood from the heart to the body (aorta) is in the wrong place. Instead of its usual connection to the left pumping chamber of the heart (left ventricle), the aorta is connected to the right pumping chamber (right ventricle).

This surgery is done to create normal blood flow through the heart. It may be done in stages, with the first surgery done soon after birth.

Tell your child’s 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 anesthetic medicines.
Any bleeding problems you child has.
Any surgeries your child has had.
Any medical conditions your child has.

What are the risks?

This is a complex surgery. Problems may occur, including:

Bleeding.
Infection.
Damage to the nerves or muscles in the chest.
Damage to the electrical system in the heart.
Strokes.
Blood clots.
Kidney failure.
Lung (respiratory) failure.

What happens before the procedure?

Medicines

Ask your child’s health care provider about:

Changing or stopping your child’s regular medicines. This is especially important if your child is taking diabetes medicines or blood thinners.
Giving your child medicines such as aspirin and ibuprofen. These medicines can thin your child’s blood. Do not give these medicines unless the health care provider tells you to give them.
Giving your child over-the-counter medicines, vitamins, herbs, and supplements.

When to stop eating and drinking

Follow instructions from your child’s health care provider about what your child may eat or drink before the procedure. These may include:

8 hours before the procedure
- Your child must stop eating meat, fried foods, or fatty foods.
- Your child may eat only light foods, such as toast and crackers.
- Your child may drink most liquids. Do not give your child energy drinks.
6 hours before the procedure
- Stop giving your child milk. Stop giving your baby formula.
- Clear liquids, such as water, clear fruit juice, and sports drinks, are okay.
- Your baby may continue to have breast milk.
4 hours before the procedure
- Give only clear liquids to your child, such as water, clear fruit juice, and sports drinks.
- Stop giving your baby breast milk.
2 hours before the procedure
- Have your child stop drinking all liquids.

If you do not follow the health care provider’s instructions, your child’s procedure may be delayed or canceled.

General instructions

If your child is already in the hospital, an IV will be placed before surgery. Fluids may be given through the IV.
Your child may need to be in the hospital for a few days or weeks to recover after the surgery. Make plans for someone to stay with your child every night, if possible.
Ask your child’s health care provider what steps will be taken to help prevent infection. These steps may include:
- Washing skin with a germ-killing soap.
- Giving your child antibiotic medicine.

What happens during the procedure?

Your child may be given:
- A medicine to help him or her relax (sedative).
- A medicine to make him or her fall asleep (general anesthetic).
A machine called a ventilator will be used to help your child breathe.
Your child will have several tubes put in, including:
- A tube that goes into the windpipe so that breathing can be managed during surgery.
- More IVs. These may be needed to give medicines and other fluids.
- A small tube that goes from the nose down to the stomach (nasogastric tube).
- A tube that lets urine drain from the body (urinary catheter).
An ultrasound test will be done to create pictures of your child’s heart.
An incision will be made through the breastbone or under the arm.
Your child may be connected to a heart–lung bypass machine. This machine will pump blood through the body to provide your child with oxygen during the procedure. The machine will take over the work of the heart and lungs while the heart is being repaired.
Your child’s heart will be repaired.
Your child will be taken off the heart–lung bypass machine.
Medicine may be given to help the heart beat well.
A small, clear chest tube will be placed in the area. It will be used to drain extra fluid and air from the chest.
Electrical wires may be put in to make sure the heart is working normally. These are usually temporary.
The incision will be closed with stitches (sutures) or staples.
A bandage (dressing) will be placed over the incision.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

Sensors clipped to a baby's feet to monitor the baby.

If your child is a newborn, he or she will be brought to the neonatal intensive care unit (NICU). If older, your child will be brought to the intensive care unit (ICU).
Many of the tubes and wires placed during surgery will be left in place during the first few hours or days of recovery.
Your child may still be on a ventilator.
X-rays and blood tests will be done.
Your child’s blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until your child leaves the hospital or clinic.
Your child may get medicine to improve blood pressure.
Over time, your child will need to be monitored less and less. Tubes will be removed, and your child will be taken off the ventilator to breathe on his or her own.

Summary

Double-outlet right ventricle surgery is a procedure to repair a heart defect that makes it hard for your child’s heart to pump oxygen-rich blood to the body.
Follow instructions from your child’s health care provider about giving your child medicines before the procedure.
Your child may be in the hospital for a few days or longer. Make plans for someone to stay with your child every night, if possible.
Your child will be monitored closely until he or she leaves the hospital or clinic.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.

Medical knowledge, Patient Education

Double-Outlet Right Ventricle Surgery, Pediatric

Tell your child’s health care provider about:

What are the risks?