Preparing for Heart Surgery

To help make your child's stay as easy and comfortable as possible, we have prepared this guide to preparing for your child's cardiothoracic surgery. If you have further questions, please ask your child's doctor or nurse.

For your convenience, you can download a copy of our surgery guides.

Helpful Hints Surgery Guide
Consejos utiles: La cirugia cardiaca de su hijo

Preoperative visit

On the morning of your child's scheduled preoperative visit, you will need to register in Patient Registration on the first floor of Cook Children's Medical Center, near Starbucks and Camelot Court. Following registration, you will be escorted to the Surgery Check-in area on the second floor of the medical center.

A nurse and nurse practitioner will complete a medical history and physical exam of your child, including a weight and height measurement. You may also meet with an anesthesiologist during the visit. Your child will have a chest X-ray and blood work done. Your child also may have an echocardiogram and/or electrocardiogram.

You will receive instructions regarding what to expect on the day of surgery, diet restrictions, bathing instructions and when to arrive for surgery.

Cardiac Intensive Care Unit tour

If you would like to have a tour of the medical center and the Cardiac Intensive Care Unit, we are happy to arrange this for you. Please call us to schedule at 682-885-6400.

Talking to your child about surgery

Many families find it difficult to talk with their child about his/her upcoming surgery. We suggest that you give your child honest, age-appropriate information, so he/she won't worry or be surprised. Involve your child in getting ready for surgery. Let them help with things like shopping for Popsicles™ or packing a favorite toy to take to the hospital. Using a toy doctor's kit or drawing pictures of the hospital also can help your child express thoughts. Reading a book about hospitals (check your local library) can be a good starting point for discussion. If you would like additional assistance, contact the outpatient surgery child life specialist at 682-885-1636. Suggested books include:

It's my heart by the Children's Heart Foundation.
"Why Am I Going to the Hospital?" by Claire Ciliotta and Carole Livingston.
"A Big Operation" by Richard Scarry.
"Why Am I Going to the Hospital?" by Claire Ciliotta and Carole Livingston
"A Big Operation" by Richard Scarry
"Going to the Hospital" by Fred Rogers
"Franklin Goes to the Hospital" by Paulette Bourgeois and Brenda Clark
"KoKo Bear's Big Earache-Preparing Your Child for Ear Tube Surgery" by Vicki Lansky
"Chris Gets Ear Tubes" by Betty Pace

The night before surgery

It is important that your child get plenty of rest before surgery. Be sure your child bathes and washes his/her hair. This helps us, and helps your child feel better while recovering.

Be sure your child has a well-balanced dinner the night before surgery. Give him/her plenty to eat and drink just before the food and drink cut-off time specified by your doctor. After the cut-off time, be sure that your child has absolutely nothing to eat or drink, not even hard candy, gum, water or ice. It is even best not to brush his/her teeth, as some of the water or toothpaste may accidentally be swallowed.

For your child's safety, it is important that his/her stomach is completely empty before they are given anesthesia. Serious complications could arise with even small amounts of food or water in the stomach. Since children forget and may help themselves to food, they will need to be closely watched. If your child accidentally eats or drinks anything after the cut-off time, you must notify the nursing staff so that proper precautions can be taken.

The day of surgery: check-in

When you arrive, you will need to go to the Surgery Check-in area. When it is time to prepare your child for surgery, you will be accompanied to the room where you will begin your day.

During surgery

You may stay with your child and accompany him or her to the preoperative holding area. When your child goes into the operating room, you will be asked to go to the cardiac waiting room. We request if you have many family members and friends with you, to wait in the larger waiting room. While your child is in surgery, you do not have to stay in the waiting room, as long as a member of the operating room staff has your contact information.

After surgery

Your child will be admitted to the Cardiac Intensive Care Unit to be monitored for the initial phase of their recovery. There will be a dedicated team to care for your child consisting of cardiac intensivists and specialized cardiac nurses.

Your child will have some or all of the following:

An incision down the middle of the chest (sternotomy) or the side of the chest (thoracotomy), which is covered with either an opaque dressing or an adhesive bandage
A breathing tube to assist with breathing
IV lines to give medications and nutrition
An arterial line to monitor blood pressure and obtain blood samples
A bladder catheter to monitor urine output
A chest tube to collect fluid from the chest
Pacing wires to allow caregivers to help the heartbeat at a certain rate
An intracardiac line to monitor pressure in the heart
A continuous EKG monitor to assess heart rate and rhythm
A pulse oximeter to monitor oxygen level in the blood
A sensor on the forehead and/or back to monitor oxygen level in the brain and kidneys

Nursing care

Your child will receive one-on-one nursing care initially after surgery. As your child's condition improves, the monitoring devices and lines will be removed. Your child's progress will determine his or her length of stay in Cardiac Intensive Care Unit.

Visitation guidelines

Parents are encouraged to visit as often as they feel comfortable. Parents are welcome to stay overnight but please note, the amount of space in the rooms is limited. You will receive specific visitation information from the Cardiac Intensive Care Unit staff members regarding your child, based on his or her condition. Due to the sensitive and sometimes critical nature of cardiac surgery, these guidelines are important to protect your child's health during your stay. Child Life specialists are available to help you prepare your children for all they will see and experience; your nurse will assist you in arranging this.

A parent is welcome to stay with the child at all times. We encourage you to take breaks from your child's bedside to eat, drink and rest. There is a microwave, refrigerator, shower and lockers in a designated area available for your use. Towels for the shower are provided.

After the Cardiac Intensive Care Unit

Your child will be transferred to another floor for the remainder of your stay. Pediatric nursing staff members, Child Life specialists, a cardiologist and nurse practitioners will care for your child until it is time to return home.

When you receive the bill

Cook Children's will bill your insurance company, if applicable, for your child's surgery. When payment is received from your insurance company, you will be billed for the outstanding balance. Accounts left unpaid may be referred to a collection agency.

You will also be billed separately by one or more physicians who care for your child. This might include radiologists, pathologists, anesthesiologists or surgeons. For any questions relating to your account or to request an itemized statement, please call Patient Accounting at 682-885-4432. For families outside area codes 817 or 682, the toll free number is 1-888-852-6635.

If you have questions about your insurance, please read your insurance card, policy or other material from the company to find a phone number to call for information. If your employer provides insurance, you may also call your employer's benefits office for assistance.

Methods of payment

Self-pay patients: Self-pay means that you are responsible for paying 100 percent of the bill. You will receive a statement every 30 days until the balance is paid in full. You may also receive letters more frequently. A deposit will be required at the time of service or you can call Patient Accounting to arrange a payment plan.

HMO/CHIP patients: We will bill your HMO (health maintenance organization) for approved services, so please be sure that all information about your policy is accurate and up-to-date and present your current insurance card at registration. You will not receive a bill from the medical center unless your co-payment is not paid in full. Contact your insurance company directly for information regarding your payment. Co-payments are due at the time of registration. If you have CHIP (also known as TexCare Partnership), you may owe a co-payment to Cook Children's.

Commercial insurance: We will bill your insurance company, so please be sure that all information about your insurance is accurate and up-to-date and present your current insurance card at registration. When your insurance company pays the medical center, you will receive an explanation of payment from the company. The portion you owe the medical center will be billed to you after payment is received from the insurance company. This may take up to three months.

Medicaid/CSHCN: Please present your Medicaid/CSHCN card at the time of registration so that we may bill on your behalf for approved services. If accurate Medicaid/CSCHN information is provided, you will not receive any bills from the Medical Center.

Medicare: We will bill Medicare on your behalf and you will receive a bill for any remaining charges.

Financial assistance: We strive to assist all families in working with their specific financial needs. Insurance verification is not a guarantee for payment. If your insurance provider denies payment, please work with us to find other possible programs to assist you.

Charity medical treatment is also available to qualified families. Qualification is determined by family size and income, as outlined in the Federal Poverty Guidelines posted in Patient Registration and other areas of the medical center. For more information, contact Patient Accounting.

As required by state law, Cook Children's Medical Center files an annual report of its community benefits plan with the Bureau of State Health Data and Policy Analysis of the Texas Department of Health. The report is public information and is available upon request from the Texas Department of Health, 100 West 49th Street, Austin, Texas 78756.

Important phone numbers

Operator

682-885-4000
Information Desk and Patient Room Information

682-885-6000
Admission Counselors

682-885-4225
Case Managers

682-885-4119
Cashier

682-885-4784
Chaplain

682-885-4030
Emergency Room

682-885-4093
Family and Social Services

682-885-4119
Financial Counseling

682-885-4225
Medical Center School

682-885-4178
Lost and Found

682-885-1047
Medical Records

682-885-4351
Patient Accounting

682-885-4432
Patient Advocates (located in the Emergency Room)

682-885-4093
Patient Representatives

682-885-5325
Rehabilitation Services

682-885-4063
Ronald McDonald House

817-870-4942
Translation Services

682-885-4119
Volunteer Services

682-885-6208
Nursing stations – ask your nurse where your child is hospitalized:
Nursing stations – ask your nurse where your child is hospitalized:
2 North

682-885-6586
3 Pavilion

682-885-3360
4 North

682-885-4279
4 South

682-885-4357
5 North

682-885-4263
5 South

682-885-4130
6 North (Transitional Care Unit)

682-885-4388
6 South

682-885-1055
6 Southwest

682-885-3626
Pediatric Intensive Care Unit 8

682-885-4268
Newborn Intensive Care Unit (A)

682-885-4382
Newborn Intensive Care Unit (B)

682-885-2245
Newborn Intensive Care Unit (A)

682-885-5999

We're here to help.

If your child has been diagnosed, you probably have lots of questions. We can help. If you would like to schedule an appointment, refer a patient or speak to our staff, please call our offices at 682-885-2140.