A child’s heart surgery is difficult, since the blood vessels and structures are still very small. If the child has already had heart surgery, there may be solid fracture unions. In case of severe heart defects, such as an underdeveloped pulmonary artery, the absence of a heart valve, or a hole in the interventricular septum, surgeons have to operate on an open heart. To perform such an operation, they open the chest of the child and stop the heart. At this time, the blood is pumped through the body by the cardiopulmonary bypass system. The body is cooled during the operation so that the heart remains completely immobile.
The underdeveloped pulmonary artery is dilated with a tube (shunt). The “Gore-Tex” shunt is only a few millimetres in size. Suturing it on a tiny point at the junction of the pulmonary artery and the right ventricle is a laborious delicate task. The junction on the pulmonary artery (anastomosis) is additionally glued for durability.
The shunt does not grow with the child and needs to be replaced with a wider opening if symptoms such as lack of air and weakness appear again. When being replaced, the old shunt remains in the child’s body. It is cut across and sutured up.