The Importance of the Children's Hospital Team for the Family with a Child in Need of Heart Surgery

Imagine that your family has moved to a new country and you have to learn a new language.  You have a young child in need of well child check ups in preparation for starting a new school in the Fall.  You need the assistance of an interpreter at that Doctors visit for your child.  At the close of this appointment, the interpreter is relaying some information that you were never expecting- the fact that your child has a suspicious heart murmur and the pediatrician wants to refer your family to the Pediatric Cardiologist ASAP for further testing.  In fact, they are calling directly to see if they can see your child that very same day.

A flurry of questions are shot at you via the interpreter like -“was this ever addressed in your home country… When was the last time your child had a complete physical?”… etc.  You do your best to digest all of this while also explaining, again via interpreter assistance, that in your home country medical visits scarce and inconsistent.  Nothing was ever mentioned about your child’s heart anomaly.

On top of this news, you also hear something asked about your child’s teeth and you think “why is that important?!”  The pediatrician looks in your child’s mouth and shakes her head.  The interpreter explains the following to you “Dental clearance before heart surgery is necessary to check for, and eliminate, any potential sources of infection (cavities are full of bacteria called Strep Mutans,) which can enter the bloodstream and travel to the surgery site, causing subsequent complications such as infective endocarditis which is potentially life-threatening”. 

As a parent, you feel overwhelmed which is understandable.  Your child will see us next in the hospital pediatric dental clinic to determine the extent of  dental disease in their mouth and then determine a plan.  We want to eliminate the sources of bacterial infection by fixing this via dental appointments in our clinic or via comprehensive dental care under general anesthesia if that is appropriate (AAPD guidelines would need to apply).  This would be considered an emergent situation with the goal being to eliminate all sources of dental disease quickly so that needed heart surgery can commence in a timely manner.

This all took a TEAM in order to help this family navigate a serious diagnosis and eventual therapeutic intervention in a life saving procedure for a child.  Starting with the hospital staff comprised of volunteers to help guide our families to the correct floor, the interpreter that helps us all understand each other, the care coordination nurse that puts all the pieces of the puzzle together to ensure all needed appointments are made with each different specialty, the staff and specialists of Pediatric Cardiology to our staff and dental assistants here in our Pediatric Dental Clinic- it all requires us to work together for the good of the child and their family.  We have social workers that help us, Child life specialists that come bedside and help the child cope through their surgical experience, the Pediatric Anesthesiologist that specializes in seeing children and makes that family feel better and more secure about their child going under general anesthesia safely.  There are so many other people that contribute to this cause that I can’t mention them all.  Communication is a must in these circumstances.