What do we need to do before congenital heart surgery?

1. If at all possible, it is important that the patient be free of infection prior to going to surgery. This includes dental cavities, so a dental check-up and any dental work required should be completed within 6 weeks prior to surgery. A letter is required from the dentist clearing the patient for surgery. In addition, if the patient develops other signs and symptoms of an infection, such as a fever, runny nose, diarrhea, or vomiting, contact the surgeon’s office immediately.
2. Please contact your insurance company to verify insurance and determine whether a referral is required. 
3. If the patient is taking aspirin, contact the cardiologist to ask when to discontinue taking the aspirin.  Aspirin is generally discontinued 14 days prior to surgery to minimize the risk of excessive bleeding. However, there may be a medical reason to continue the aspirin, so it is important to check with the cardiologist.
4. Patients who live more than an hour’s drive away from Texas Children’s Hospital will need to make arrangements to stay in Houston for at least one full week after discharge from the hospital. This is important to ensure a rapid response to any early post-operative issues. The Texas Children’s Hospital Social Worker can assist if any help is needed making arrangements for this.
5. If the patient is due for immunizations within a week of surgery, contact the Congenital Heart Surgery Clinic and ask to speak to the clinic nurse.
6. Patient’s undergoing cardiac surgery frequently need blood products. Patients and families interested in donating blood should call the Congenital Heart Surgery Clinic and ask to speak to a clinic nurse.  Families and friends may donate blood in one of two ways:

• Credit:  For each unit of blood donated, a credit will be given on the patient’s bill, but the blood donated will not specifically be designated for the patient. Blood donated can be any blood type.
• Designated (or Directed) Donation:  Blood donated will be used for the patient designated. For congenital heart surgery patients, blood donors must be the same blood type as the patient. For “Designated Donation,” it is very important before you donate that you call the surgeon’s office to let us help you coordinate the donation. The pertinent patient information we need when you call is:
• the patient’s weight
• blood type
• surgery date
• type of surgery
• The best time to donate blood is one week prior to surgery and no later than three days prior to surgery.  There is a cost associated with directed donor blood that may not be covered by your insurance.  It will be the family’s responsibility to cover the cost of directed donor blood that is not covered by insurance.
1. If the patient is taking “blood thinners” such as Coumadin or Lovenox, please contact the Congenital Heart Surgery Clinic and ask to speak to the clinic nurse.  These patients may need to be hospitalized a few days prior to surgery to discontinue these medications and convert to Heparin prior to surgery.  This decision will be coordinated between the patient, surgeon and cardiologist.
2. Registration and admission into Texas Children’s Hospital is usually scheduled to occur the day before surgery.  Patients and their families should arrive at 8:00 a.m. in the Congenital Heart Surgery Clinic located on the 20th floor of the West Tower.  We conduct a very thorough pre-operative work-up in order to attain the very best surgical outcome for the patient, so the preoperative work-up will take several hours.  A cardiologist performs a physical exam and multiple tests will be performed to ensure the patient is well for surgery.  A chest x-ray (CXR), an electrocardiogram (EKG), and lab work will be performed as part of the preoperative process.  A Congenital Heart Surgery clinic nurse will facilitate your day.  You will also meet many members of the Heart Center team who will familiarize you with the preoperative routines and answer any questions.  These team members include: the Social Worker, Child Life Specialist, Chaplain, and the Congenital Heart Surgery Anesthesiologist.  At the end of the pre-operative work-up, you will either be admitted to the 15 Tower Cardiac Inpatient Unit or sent home to return the following early morning for surgery.  Valet parking is available at the West Tower building.  If you choose to valet park the day of your preoperative work-up, bring your parking ticket with you and the Congenital Heart Surgery clinic nurse will validate parking for the day of your preoperative work-up. It will be your responsibility to pay for parking throughout the remainder of your hospital stay.