A child’s open-heart surgery usually takes about 3 to 6 hours, although more complex procedures may take longer. During the operation, the child is placed on a heart-lung machine. After surgery, most children require 2 to 4 days in the ICU, followed by a total hospital stay of around 5 to 7 days. In more complex cases, recovery in the hospital can extend to several weeks.

“Families fixate on the duration in the waiting room and I understand why but the number that actually matters isn’t how long the surgery took it’s what the surgeon says when they come out to tell you how it went,” says Dr. Prashant Bobhate, Pediatric Cardiologist in Mumbai, India.

The anatomy underneath the diagnosis is what sets the surgical clock and two children with the same condition can have repairs of very different complexity and duration depending on what the surgeon actually encounters.

• Defect type: Simple secundum ASD or isolated VSD closures are among the shorter cardiac procedures, while complex repairs involving outflow tract reconstruction, valve work or multiple simultaneous defects add significant time under bypass that straightforward closures don’t need.
• Bypass time: The time the heart is stopped and the child is on cardiopulmonary bypass is the most clinically significant part of the duration because longer bypass times carry a higher risk of post-operative complications, and surgeons manage this carefully, not just to be efficient but because it directly affects outcomes.
• Unexpected findings: Sometimes the anatomy is more complex than the pre-operative echo suggested, an additional defect is found, a valve is more abnormal than imaging showed or tissue quality requires a different repair approach and all of these extend theatre time in ways nobody could predict before opening the chest.
• Redo surgery: A child who has already had one cardiac operation and needs a second carries scar tissue, adhesions and altered anatomy from the first repair and dissecting through that safely adds significant time before the actual correction even begins.

Understanding what a child’s specific defect requires in terms of surgical repair and what the recovery looks like afterwards is exactly what a thorough congenital heart disease consultation maps out before any theatre date is confirmed.

The hardest hours most cardiac families will ever sit through.

• Bypass team updates: Most centres provide a liaison nurse or team member who updates the waiting family at key surgical milestones and if your centre doesn’t offer this ask specifically before admission day because waiting six hours in silence is genuinely harder than it needs to be.
• Why it’s taking longer: A surgery running over the estimated time doesn’t automatically mean something has gone wrong and it’s often the surgeon being more careful or finding something that needed extra attention rather than an emergency and the team should be telling you which it is.
• Anaesthesia and bypass monitoring: While the surgeon works a separate team manages the bypass circuit, the anaesthesia, the child’s temperature, blood pressure and organ perfusion continuously and the size of the team in that theatre is something most families never see and would find reassuring if they did.
• Coming out of bypass: Weaning the heart off cardiopulmonary bypass and restoring normal rhythm is a distinct phase at the end of the operation that can itself take thirty minutes to an hour and families told the surgery is finishing should expect another wait before the surgeon actually appears in the waiting area.

Parents wanting to understand what the warning signs of cardiac deterioration look like in children in the days and weeks after open heart surgery should read this piece on the top 5 warning signs of pediatric heart failure, because knowing what to watch for at home is as important as understanding what happened in the operating theatre.

A family sitting in a waiting room for four hours deserves a team that keeps them informed, prepares them before the surgery for what longer theatre times might mean and doesn’t leave them alone with catastrophic imagination filling the silence. That preparation starts at the pre-surgical cardiology appointment not on the day. Dr. Prashant Bobhate has spent over 12 years preparing families for paediatric cardiac surgery across every defect type and complexity at the Children’s Heart Centre, Kokilaben Dhirubhai Ambani Hospital. Escorts Heart Institute New Delhi.

• Congenital Heart Defects, MedlinePlus, U.S. National Library of Medicine — https://medlineplus.gov/congenitalheartdefects.html
• Congenital Heart Defects, National Heart Lung and Blood Institute — https://www.nhlbi.nih.gov/health/congenital-heart-defects

Most children go home within one to two days of VSD device closure and return to normal activity within one to two weeks. No chest opening, no bypass, no long ICU stay. But faster recovery doesn’t mean no recovery, and the first month after the procedure carries specific restrictions, medications, and follow-up echo requirements that need to be followed properly for the device to settle safely into position.

“Parents are often surprised by how quickly their child bounces back after device closure compared to what they were imagining open heart surgery would look like, and that’s genuinely one of the things that makes catheter-based closure the right answer when the anatomy supports it,” says Dr. Prashant Bobhate, Pediatric Cardiologist in Mumbai, India.

The first 48 hours are monitored, structured, and very different from what families imagine open-heart recovery involves because this procedure doesn’t touch the chest wall at all.

• Same day monitoring: After the procedure, the child is observed in a monitored bed for several hours to confirm the device is sitting correctly, the heart rhythm is stable, and there’s no significant residual shunting visible on the post-procedure echo before anyone talks about the ward.
• Hospital stay: Most children spend one night in the hospital after uncomplicated device closure and are discharged the following morning once the team is satisfied with the rhythm, the echo findings, and the child’s overall clinical status.
• Catheter site care: The entry point in the femoral vein or artery needs to be kept clean and dry for several days, and physical activity that strains the groin area needs to be avoided for at least a week to allow the access site to heal without complication.
• Going home medications: Aspirin for antiplatelet cover is prescribed for six months after most VSD device closures to reduce the risk of clot formation on the device surface while the heart tissue grows over it, and this medication needs to be given exactly as prescribed without gaps.

Understanding what the full picture of VSD management looks like from diagnosis through closure through long-term follow-up is exactly what a thorough ventricular septal defect assessment maps out before any intervention decision gets made.

More specific than most families expect from a catheter procedure.

• First two weeks: No running, jumping, contact sport or rough play because the device is still embedding into the septal tissue and any significant physical impact during this window carries a small but real risk of device displacement before tissue ingrowth is complete.
• Return to school: Most children can return to school within one to two weeks but need to be excused from physical education, sports and any activity involving physical contact for the full first month until the follow-up echo confirms the device is stable and well positioned.
• One month echo: This is the most important follow-up appointment in the entire post-closure period because it confirms device position, checks for residual shunting, assesses the rhythm and determines whether the antiplatelet medication continues or can be reviewed at the next visit.
• Six month review: A second echo at six months confirms complete tissue coverage of the device, checks valve function on both sides of the septum and gives the cardiologist the information needed to formally close the active surveillance phase or flag anything that needs continued monitoring.

Parents wanting to understand what cardiac warning signs look like in children in the weeks after any cardiac procedure should read this piece on top 5 warning signs of pediatric heart failure because knowing what to watch for at home is as important as knowing what happened in the catheterisation lab.

VSD device closure isn’t just the procedure on the day. It’s the echo assessment that confirms the anatomy supports a device, the catheterisation performed precisely enough that the device sits without residual shunting, and the follow-up plan that catches anything that changes in the months after. All of that in one place. Dr. Prashant Bobhate has spent over 12 years performing catheter-based VSD closures and managing the full post-procedure surveillance pathway at the Children’s Heart Centre, Kokilaben Dhirubhai Ambani Hospital. Escorts Heart Institute, New Delhi. Fellowship at the University of Alberta, Canada. Over 400 children are on active cardiac therapies right now. He doesn’t hand a family a discharge summary and step back. He follows the device until the heart has made it its own.

📞 Call Now: (+91) 8080 826 898 A proper VSD assessment tells you whether device closure is anatomically possible for your child, what the procedure involves, and exactly what the recovery and follow-up plan looks like from day one through six months.

• Ventricular Septal Defect, MedlinePlus, U.S. National Library of Medicine — https://medlineplus.gov/ency/article/001099.htm
• Congenital Heart Defects, National Heart Lung and Blood Institute — https://www.nhlbi.nih.gov/health/congenital-heart-defects

Ask everything. Before the surgery date is the only time every question has a calm, considered answer. What defect is being repaired and why now. What the procedure involves step by step. What the ICU will look like when you first see your child after. What the recovery timeline is. What the risks are for this specific child, not the average child in a textbook. Write them down. Bring the list.

“I tell every family the same thing at the pre-surgical appointment. If you leave this room with an unanswered question that’s on me not on you. Ask it again, ask it differently, ask it as many times as you need until the answer actually makes sense to you,” says Dr. Prashant Bobhate, Pediatric Cardiologist in Mumbai, India.

The clinical questions are the ones most families forget to ask because the emotional weight of the appointment crowds them out and then they remember them at two in the morning three days later.

• Why now: Ask specifically why surgery is recommended at this point rather than earlier or later because the timing of paediatric cardiac surgery is a deliberate clinical decision based on pressure measurements, growth trajectory and ventricular function and you deserve to understand the reasoning not just accept the date.
• What exactly happens: Ask the surgeon to walk through the procedure in plain language, what the chest opening involves, how bypass works, how long the heart will be stopped and what the team does during that time because parents who understand the steps are far less consumed by catastrophic imagination in the waiting room.
• What are the real risks: Ask for the specific risks for your child’s defect and age not a generic list off a consent form because a VSD closure in a healthy eight month old carries different risk than the same procedure in a child with rising pulmonary pressures or a concurrent infection and you need to understand which conversation you’re actually in.
• What does success look like: Ask what a good outcome means for this specific defect because for some repairs success means complete correction and a normal life and for others it means significant improvement with ongoing monitoring and that distinction matters enormously for how a family orients their expectations going forward.

Getting a full picture of what paediatric cardiac intervention involves and what specialist-level care looks like before making any surgical decision is exactly what a thorough congenital heart disease consultation provides before any admission date is set.

Equally important. Most families forget these entirely.

• ICU timeline: Ask how long your child is expected to be in cardiac ICU, what they’ll look like when you first see them after surgery and which tubes, lines and monitors to expect because the first post-operative ICU visit is significantly less frightening when you’ve been told in advance what you’ll see walking through that door.
• Pain management: Ask specifically how pain is managed in the post-operative period because a child in uncontrolled pain after cardiac surgery recovers more slowly and parents who advocate clearly for adequate analgesia get better outcomes than those who assume the team will manage it without being asked.
• Discharge criteria: Ask what the team needs to see before your child goes home because families who know the specific milestones, feeding tolerance, oxygen levels, wound healing, understand why discharge is or isn’t happening rather than feeling helpless in a waiting pattern with no visible end.
• Follow-up schedule: Ask exactly when the first post-operative echo is, what it’s looking for, who does it and what would prompt an earlier return because going home after open heart surgery without a clear follow-up plan in hand is something no family should accept at discharge regardless of how busy the ward is.

Parents wanting to understand what the warning signs of cardiac deterioration look like in children in the weeks after any major cardiac procedure should read this piece on top 5 warning signs of pediatric heart failure because knowing what to watch for at home is as important as knowing what happened in the operating theatre.

A family walking into a pre-surgical appointment deserves a cardiologist who has time for every question including the ones they’re embarrassed to ask and the ones they don’t yet know they need to ask. Not a fifteen minute slot before the next patient. A real conversation that leaves nobody confused about what’s coming. Dr. Prashant Bobhate has spent over 12 years preparing families for paediatric cardiac surgery across every defect complexity and every level of prior medical knowledge at the Children’s Heart Centre, Kokilaben Dhirubhai Ambani Hospital. Escorts Heart Institute New Delhi. Fellowship at University of Alberta Canada. Over 400 children on active cardiac therapies right now. He doesn’t move on until the family understands. That’s not a service promise. It’s just how the appointments run.

📞 Call Now: (+91) 8080 826 898 A proper pre-surgical consultation answers every question about the procedure, the recovery and what comes after so your family walks into that surgery date knowing exactly what to expect at every stage.

• Congenital Heart Defects, MedlinePlus, U.S. National Library of Medicine — https://medlineplus.gov/congenitalheartdefects.html
• Congenital Heart Defects, National Heart Lung and Blood Institute — https://www.nhlbi.nih.gov/health/congenital-heart-defects

Preparation starts weeks before the surgery date not the night before. The surgical team needs blood work, echo, anaesthesia assessment and medication adjustments done in advance. Parents need to understand what the pre-op protocol requires, what to expect on admission day and what the ICU looks like after the operation so the first time they see any of it isn’t also the most frightening day of their child’s life.

“The families who come in most prepared are almost always the ones who asked every question at the pre-surgical appointment rather than waiting until they were standing outside the OT. There are no foolish questions before open heart surgery on a child. None,” says Dr. Prashant Bobhate, Pediatric Cardiologist in Mumbai, India.

It’s more structured than most parents expect and every step has a reason behind it that the team should be explaining clearly rather than handing over a checklist without context.

• Pre-op investigations: Blood counts, coagulation profile, kidney and liver function, chest X-ray and a final echo confirming the surgical anatomy are all completed before admission and any abnormal finding at this stage changes the surgical timing or approach so nothing gets skipped.
• Medication adjustments: Some cardiac medications need to be continued right up to the morning of surgery while others including certain diuretics and anticoagulants need to be stopped days before and getting this wrong at home is one of the most common avoidable pre-surgical complications families face.
• Fasting instructions: Specific fasting windows for solids and liquids vary by the child’s age and the anaesthetic protocol and following them exactly matters because a full stomach on the morning of cardiac surgery under general anaesthesia creates a real risk that strict fasting eliminates entirely.
• Infection check: Any active respiratory infection, fever, skin infection or dental procedure in the weeks before scheduled cardiac surgery is grounds for postponement because operating on an infected child under bypass carries risks that simply aren’t worth taking when postponing two weeks eliminates them.

Understanding what the recovery period looks like after a paediatric cardiac procedure and what warning signs to watch for is exactly what a thorough pediatric heart failure management consultation covers before any surgical admission is confirmed.

Honestly. Without pretending it’s nothing.

• Age-appropriate honesty: A four year old and a twelve year old need different conversations but both need something true and a child who is told nothing and then wakes up in a cardiac ICU with tubes and monitors everywhere is dealing with shock on top of surgery which is genuinely harder to recover from than one who knew roughly what to expect.
• Hospital visit beforehand: Some centres allow families to see the ICU and recovery area before admission day and for older children especially this single visit removes more anxiety than any amount of reassurance at home because the imagined version of an ICU is almost always worse than the actual one.
• Siblings and family: Other children in the family need age-appropriate information too because a sibling who is told nothing and then sees a parent disappear to a hospital for days while the house goes quiet experiences a kind of fear that honest simple words beforehand would have reduced significantly.
• Your own anxiety: Children read their parents more accurately than most parents realise and a parent who is visibly terrified on admission morning makes a frightened child more frightened regardless of what words are being said so getting your own questions fully answered at the pre-surgical appointment isn’t just for you it’s directly for them.

Parents who want to understand what cardiac warning signs look like in children before any surgical admission becomes the conversation should read this piece on how to spot the early signs of heart disease in neonates because the earlier the right team is involved the more time there is to prepare properly rather than rushing.

Open heart surgery on a child is not a day. It’s a process that starts at the first cardiology appointment and doesn’t end at discharge and families need a team that treats it that way rather than handing them a surgery date and a pre-op checklist and calling that preparation. Dr. Prashant Bobhate has spent over 12 years walking families through the full arc of paediatric cardiac care from initial diagnosis through surgical planning through post-operative recovery and long term follow up at the Children’s Heart Centre, Kokilaben Dhirubhai Ambani Hospital. Escorts Heart Institute New Delhi. Fellowship at University of Alberta Canada. Over 400 children on active cardiac therapies right now. He makes sure families know exactly what’s happening and why at every single step.

📞 Call Now: (+91) 8080 826 898 A proper pre-surgical assessment tells you exactly what your child needs before the operation, what to expect during recovery and what the follow-up plan looks like so nothing about the process comes as a surprise.

• Congenital Heart Defects, MedlinePlus, U.S. National Library of Medicine — https://medlineplus.gov/congenitalheartdefects.html
• Congenital Heart Defects, National Heart Lung and Blood Institute — https://www.nhlbi.nih.gov/health/congenital-heart-defects

Yes. Ayushman Bharat PM-JAY covers several congenital heart surgeries including VSD closure, ASD repair, TOF correction and PDA ligation under its cardiac surgery packages and eligible families pay nothing out of pocket at empanelled hospitals. Private health insurance also covers congenital heart surgery in most cases but waiting periods, sub-limits and what counts as a covered procedure vary significantly between policies and need to be verified before admission not after.

“Families who qualify for Ayushman Bharat often don’t know their child’s surgery is covered until someone tells them specifically and that gap between entitlement and awareness is something I try to close at the very first appointment because it changes everything about what’s actually accessible to them,” says Dr. Prashant Bobhate, Pediatric Cardiologist in Mumbai, India.

More than most families expect but with specific limits that matter enormously when the actual procedure is being planned and the hospital is being chosen.

• Covered procedures: VSD repair, ASD closure, TOF correction, PDA ligation, pulmonary valvotomy and several other congenital cardiac surgeries fall within the PM-JAY package list and eligible children can access these at empanelled hospitals with zero out-of-pocket cost for the procedure itself.
• Package limits: Each procedure has a fixed government package rate and when the actual cost of surgery at a private empanelled hospital exceeds that package ceiling the difference either gets absorbed by the hospital or falls on the family and understanding that gap before choosing a centre matters.
• Empanelled hospitals only: Ayushman Bharat coverage only applies at hospitals officially empanelled under PM-JAY and not every cardiac centre in Mumbai that performs paediatric heart surgery is on that list so eligibility at a specific hospital needs to be confirmed before any admission happens.
• Eligibility verification: The PM-JAY benefit is income and ration-card linked and families need to verify their eligibility through the official Ayushman Bharat portal or helpline before assuming coverage applies because assumptions at the hospital admission desk on surgery day create problems nobody needs at that moment.

Understanding what specialist paediatric cardiac care looks like at a dedicated centre and how to access it through available schemes is explored in this piece on the pediatric heart specialist at Kokilaben Hospital because knowing where the right care sits is the first step before the coverage question even becomes relevant.

Complicated. Read the policy before the surgery not after.

• Congenital condition clauses: Many older health insurance policies exclude congenital conditions entirely or impose a waiting period of two to four years before congenital heart surgery is covered and a family that discovers this on admission day faces a situation that proper policy review weeks earlier would have avoided.
• Sum insured adequacy: A policy with a Rs 3 lakh sum insured covers a simple VSD closure at a government hospital but falls significantly short of a complex TOF repair at a private tertiary centre and families need to check whether their cover actually matches the procedure their child needs at the centre their cardiologist recommends.
• Implant and device costs: Some insurers reimburse surgical fees but cap or exclude the cost of prosthetic valves, occluder devices and other implantable materials that form a significant portion of the total bill and those exclusions need to be identified in the policy document before the treatment plan is finalised.
• Cashless vs reimbursement: Cashless admission requires the hospital to be on the insurer’s network and if the best centre for the child’s specific defect isn’t on that network the family may need to pay upfront and claim reimbursement later which requires financial capacity many families in this situation don’t have.

Parents wanting to understand what the cost picture looks like for open heart surgery in Mumbai across hospital tiers and what drives the final number should read this piece on top 5 warning signs of pediatric heart failure because catching a deteriorating defect before it becomes an emergency admission is always what keeps the most affordable and appropriate options available.

A family navigating a congenital heart diagnosis while simultaneously trying to understand PM-JAY eligibility, insurance pre-authorisation and hospital empanelment needs a team that can help them work through all of it not just the clinical side. Dr. Prashant Bobhate has spent over 12 years working with families across every socioeconomic background at the Children’s Heart Centre, Kokilaben Dhirubhai Ambani Hospital and understands what it takes to make the right cardiac care accessible not just available in theory. Escorts Heart Institute New Delhi. Fellowship at University of Alberta Canada. Over 400 children on active cardiac therapies right now. He doesn’t send families away to figure out the system alone. He tells them exactly what their child needs and helps them find the clearest path to getting it.

📞 Call Now: (+91) 8080 826 898 A proper assessment tells you what procedure your child needs, whether Ayushman Bharat or your insurance covers it and what the realistic out-of-pocket picture looks like before any decision gets made.

• Ayushman Bharat PM-JAY, National Health Authority — https://pmjay.gov.in/
• Congenital Heart Defects, MedlinePlus, U.S. National Library of Medicine — https://medlineplus.gov/congenitalheartdefects.html