When open heart surgery is the best option, our pediatric heart surgeons care for patients from before birth to adulthood. The conditions we may treat with surgery include congenital anomalies such as structural heart defects and irregular heart rhythms.
Congenital Heart Surgery: Common Conditions and Treatments
Conditions that our surgeons treat include:
- Atrial septal defect (ASD)
- Ventricular septal defect (VSD)
- Patent ductus arteriosus (PDA)
- Atrioventricular (AV) canal
- Coarctation of aorta
- Hypoplastic left heart syndrome
- Tetralogy of Fallot
- Truncus arteriosus
- Total anomalous pulmonary venous return
- Tricuspid atresia
- Aortic stenosis
- Connective tissue disease
- Major aortopulmonary collateral arteries
Our surgeons work with each family and provide as much information as possible to decide if surgery is the best option for your child. Additionally, each surgery candidate is discussed at length between all members of the Heart Institute team to ensure the safest, most effective surgical techniques are used to repair your child’s heart.
Common treatments for congenital heart disease by our heart surgeons include:
- Atrial septal defect (ASD) repair
- Ventricular septal defect (VSD) repair
- Atrioventricular (AV) canal repair
- Coarctation of aorta repair
- Norwood operation
- Glenn operation
- Fontan operation
- Arterial switch operation
- Complex biventricular repair
- Unifocalization of multiple aorta-pulmonary collaterals (MAPCAs)
- Aortic root replacement
- Valve replacement and repair
- Ross procedure
- Mechanical circulatory support
- Heart transplant
- Blood conservation heart surgeries
Click here to view our heart surgery outcomes reported by the Society of Thoracic Surgeons.
Congenital Heart Surgery: What to Expect
If a cardiologist refers your child to Le Bonheur for surgery, the case will be evaluated by a multidisciplinary team to decide if surgery is the best option for your child. This team includes:
- Cardiology, including interventional cardiologists, electrophysiologists and heart failure specialists
- Cardiac surgery
- Cardiac anesthesia
- Cardiac critical care
- Perfusion
- Nursing
During this evaluation, our experts may decide that your child needs additional studies, such as new images of the heart, to make the best decision or surgery plan. We work step by step with your referring provider to make the best plan for your child and your family.
If surgery is the best option, here are some of the things you can expect:
Each child and their caregiver will have a virtual preoperative appointment with the surgical team. Meeting virtually allows for extended family to be present, adapts to the family’s schedule and minimizes travel. During this time, our team will review your child’s previous history and existing tests to understand your child’s prior care. This conversation is personalized to each family and child.
Two weeks prior to the scheduled surgery you will be asked to treat the patient with Mupirocin ointment. This helps prevent post-operative infections. You will receive detailed instructions from the Cardiac Surgery Coordinator.
One to three days prior to the scheduled surgery, you will have a preoperative appointment in person at our Cardiac Surgery Clinic. During this appointment, we will take any labs needed and complete any final tests that are necessary. These can include echocardiograms, CT scans, chest X-rays, electrocardiograms or a Holter monitor. You will be seen by a Physician Assistant (PA) dedicated to the Cardiac Surgery team and have the opportunity to ask any additional questions.
You and your child will also have an opportunity to meet with our Child Life team, who help your child understand cardiac surgery in an age-appropriate way. You can also tour the Cardiovascular Intensive Care Unit and the hospital with one of our team members.
On the day of surgery, your child and up to two adults will be taken to the preoperative area for assessment and preparation for surgery. You will meet members of the anesthesia and operating room (OR) teams and see your cardiac surgeon.
Once your child goes to the OR, families can wait in the main surgery waiting room or the Heart Institute family room that includes an outdoor space. OR nurses will call you with progress updates about every hour.
When surgery is complete, your child’s surgeon will meet with or call you, depending on your preference. Typically, you can see your child about two hours after surgery concludes.
Your child’s stay in the hospital will vary based on the type of surgery. They will be cared for by a multidisciplinary staff of cardiologists, cardiac surgeons, cardiac critical care specialists and nurses specially trained to care for children after cardiac surgery. In addition, child life specialists, social workers and chaplains are available to every family to help navigate their time in the hospital and the transition home.
After discharge from the hospital, your child will have a follow up appointment with the cardiac surgery team after one week. During this appointment, we will answer any questions and check on the healing progress of the incision. This appointment is typically held virtually – in person appointments are available at the family’s request.
Your next follow up will be with your pediatrician a week after surgery for a weight check or any other concerns. Two to four weeks after surgery, you will follow up with your referring cardiologist.
Cardiovascular Intensive Care Unit
Our 31-bed Cardiovascular Intensive Care Unit (CVICU) and Cardiac Care Unit focuses on the unique needs of critically ill neonatal and pediatric patients with congenital heart disease. Private, family rooms allow two family members to stay with our patients overnight.
Each CVICU room has state-of-the-art headwalls to allow easy access to technology for critically ill children plus built-in entertainment for kids, including a changing light display. The unit also features an outdoor, central courtyard space providing natural light and a space for patients to rehab without leaving the unit.
Our CVICU is located next to the cardiac operating rooms and catheterization labs. The proximity allows for quick transportation between all areas of the Heart Institute.
Staff in the CVICU is specially trained in cardiac care. Not only does the medical staff care for your child’s medical needs before and after heart surgery, but parent mentors are also available to offer you and your family support during your stay. Child Life specialists are also available to ease your child’s fears. For new mothers, lactation consultants and breast pumps are available during your stay in the hospital
Our CVICU has been awarded the Beacon Award of Excellence by the American Association of Critical Care Nurses. The Beacon Award means that our CVICU provides exceptional care with quality outcomes and excellent patient and family satisfaction.
Families who live more than 50 miles away from Le Bonheur may be able to stay at the FedExFamilyHouse, a free, 75-room/suite facility for out-of-town families with children receiving treatment at Le Bonheur.
Patient Highlight: Cayden Hathaway
Hypoplastic left heart syndrome, dextrocardia, heterotaxy
Daniel and Ashley Hathaway’s son, Cayden, was initially given a 5% chance of survival. His health conditions meant he would be born with half of a heart that was positioned on the wrong side of the chest and that other organs in the chest and abdomen would not be in their typical position.
After birth, Cayden was immediately taken to the children’s hospital near his home and put on medications to keep his heart open in preparation for the first of three repair surgeries. This is when Daniel and Ashley began the years long journey with the surgeon that would rebuild their son’s heart.
“We were given a list of surgeons to pick from. We read up on them, and one stood out,” said Daniel.
“We kept thinking about who had steady hands,” added Ashley.
Bret Mettler, MD, then cardiac surgeon at their local hospital, now Le Bonheur’s chief of Pediatric Cardiac Surgery, rose to the top. The Hathaways had no idea then that this choice would being a journey that led them straight into the heart of Le Bonheur.
Cayden had two surgeries at his local hospital – both surgeries with Dr. Mettler were a success. Cayden would wait until he was older for his final heart repair surgery. The Hathaway family decided they would travel wherever needed for Dr. Mettler to continue as their surgeon.
In the meantime, Dr. Mettler’s path took him away from their nearby hospital to Le Bonheur Children’s, less than 150 miles away from their home. When the time came for Cayden’s final surgery – the Fontan procedure – they were overjoyed to have their surgeon close to home again, but they found more than just a brilliant surgeon at Le Bonheur.
“Le Bonheur was less stressful – nurses and doctors would sit and listen to how we truly felt about medications and the care Cayden was getting,” said Ashley. “The mentality seems to be, ‘You know your kid best.’”
“Le Bonheur understands the pathologies of the disease but wants to know what the parents think and what’s normal for Cayden,” added Daniel. “The majority of everybody we had at Le Bonheur went above and beyond with care.”
Mettler conducted the third surgery on Cayden’s heart successfully, and Daniel and Ashley could see improvement in Cayden’s health within weeks of surgery. He now only takes aspirin and amoxicillin and is back to the things he loves – pursuing his curiosity about planets and stars, going to Sunday School and playing with other kids.
“Looking back, I couldn’t image not having this boy full of life,” said Ashley. “He has so much purpose – he’s teaching me new things every day, teaching surgeons and doctors new avenues for care and teaching us that every day is a gift.”
For more information, contact us at 1-866-870-5570.
Meet Our Cardiac Surgery Team
Cardiac Surgeons
Dr. Mettler is the co-director of the Heart Institute, professor and chief of Pediatric Cardiac Surgery and The Susan and Alan Graf Endowed Chair in Pediatric Heart Surgery at The University of Tennessee Health Science Center and Le Bonheur Children's Hospital. He specializes in the surgical repair of complex congenital heart disease, heart transplantation and mechanical circulatory support. His research interests include insights into complex congenital heart defects and the development of an artificial pulmonary valve using stem cells.
Dr. Gottlieb Sen is a pediatric cardiac surgeon and an associate professor at the University of Tennessee Health Science Center. She completed her Pediatric Cardiothoracic Surgery fellowship at New York Presbyterian Hospital and her Congenital Cardiac Surgery Fellowships at Morgan Stanley Children's Hospital and Boston Children's Hospital. Gottlieb Sen is certified by the American Board of Surgery in general, thoracic and congenital heart surgery.
Physician Assistants
Cardiac Anesthesia
Dr. Adams is a pediatric cardiac anesthesiologist in the Heart Institute at Le Bonheur Children's Hospital. He is certified by the American Board of Anesthesiology, and is an associate professor with the University of Tennessee Health Science Center. Dr. Adams completed his Pediatric Cardiac Anesthesiology fellowship at Columbia University Irvine Medical Center.
Cardiac Surgery Staff
Carla Curle, RN, BSN - Cardiac Surgery Coordinator
Jerry Allen, CCP - Chief Perfusionist
Carrie Johnson, CCP - Perfusionist
Ashley Sandvig, CCP - Perfusionist
Jean Lipford - Cardiac Surgery Administrator
