INTERPRETING PEDIATRIC CARDIAC SURGERY

1. THE HEART OF THE MATTER: INTERPRETING PEDIATRIC CARDIAC SURGERY Alejandra E. Picado

2. What Participants Will Learn From Today’s Presentation. 1. How to prepare for a cardiac pre-operative interpreting session. (Knowing your terms, procedures, and common preparations, as well as the emotional preparations.) 2. What the most common pediatric cardiac conditions are, and what the procedures are to repair these. 3. How to interpret with professionalism, while also showing compassion and helping in what little ways we can. 4. Working with the chaplains, child-life and social workers for the difficult conversations prior to surgery. 5. How interpreting a Pediatric cardiac surgery is different from adult cardiac surgeries.

3. So, As Medical Interpreters, We are Here to Serve as … • Cultural broker. • Support, • Communication manager. • Open heart

4. What Is The First Thing That Comes to Mind When You Say “Open Heart Surgery?” Terror, Anger, Desperation, Confusion!

5. How Do You Begin A Cardiac Pre-Operative Interpreting Session? • Being briefed before the encounter can make a world of difference to both you and the encounter. • Take note of the environment and silently assess. • Pre-session.

6. Very Common Terms For Interpreting Cardiac Surgery Are As Follows: • Catheterization • Heart Lung bypass machine • Chest tubes • Pacemaker wires • Steri – strips • Sternotomy / Mini-Sternotomy

7. The Session Will Begin With possible… • urine tests • blood tests • echo-cardiogram (ECG) • electro-cardiogram (EKG) • Cardiac Catheterization

8. What Are Some of the Most Common Cardiac Defects / Diagnosis in Pediatrics? • 1. PDA (Patent Ductus Arteriosis) • 2. ASD (Atrial Septal Defect) • 3. VSD (Ventricular Septal Defect) • 4. AV Canal (Atrioventricular Septal Defect) • 5. Coarctation of the Aorta • 6. TOF (Tetralogy of Fallot) • 7. AS (Aortic Stenosis) • HLHS (Hypoplastic Left Heart Syndrome) • Single Ventricle Anomalies

9. PDA (Patent Ductus Arteriosis) Allows blood to flow from the pulmonary artery to the aorta. 1.) Patent Ductus Arteriosis 2.) Ligated PDA

10. ASD (Atrial Septal Defect) A hole between the 2 upper chambers of the heart

11. VSD (Ventricular Septal Defect) A hole between the right and left pumping chambers of the heart.

12. AV Canal (Atrioventricular Septal Defect) • To make it simple: You have 4 apartments. 2 upstairs and 2 downstairs. • the whole middle wall is missing. AVSD Top view of Valve Repaired AV-Canal

13. Coarctation of the Aorta • Is a narrowing of the aorta, the main blood vessel carrying oxygen-rich • blood from the left ventricle of the heart to all of the organs of the body. • Repairs: • End to End Anastomosis • Bypass (Sub-Clavian Flap Repair) • Thoracotomy (incision on left side) Coarctation Coarctation Repair

14. Tetralogy of Fallot (TOF) An anomaly that refers to a combination of four related heart defects that commonly occur together. • Pulmonary Stenosis • Right Ventricular Hypertrophy • Overriding Aorta • VSD (Ventricular Septal Defect)

15. AS(Aortic Stenosis) • Aortic Stenosis refers to a condition that causes obstruction to blood flow • between the left ventricle and the aorta. • Valvar AS • Subvalvar • Supravalvar

16. HLHS (Hypoplastic Left Heart Syndrome) • Several abnormalities of development occur on the left side of the heart in HLHS: • Mitral stenosis (poorly formed) / Mitral atresia (not formed) • Left ventricular hypoplasia. • Aortic stenosis • Aortic atresia). • The main artery leaving the left side of the heart, the aorta, is underdeveloped. • Coarctation of the aorta Normal Hypoplastic Left Heart

17. Different Procedures to Repair HLHS (Hypoplastic Left Heart Syndrome) • Norwood • Bidirectional Glenn • Fontan 1st Repair 2nd Repair 3rd Repair

18. Single Ventricle Anomalies • Only one of the two ventricles is of adequate functional size. • Some of the anomalies described as single ventricle defects include: • Tricuspid atresia – • Hypoplastic left heart syndrome– • Double inlet left ventricle– • Many of the heterotaxy defects- • Some variations of double outlet right ventricle –

19. Working with Child Life Child life has a very important role in the hospital. They don’t just “play” with the children, but rather, they role play and make the children comfortable enough to be able to discuss or at least understand in terms that they can comprehend, what all the scary stuff is about.

20. Working with Social Work and Chaplains • Social workers are a very vital in the preparation for pediatric cardiac surgery. • Resources • Loving and support • Chaplains play a very important part in the families experience in the hospital. • Spiritual and Moral Support • Ear to listen with

21. Keeping the Professionalism while still showing compassion and heart. Even though we as interpreters should always maintain our poise and remain professional, we can’t lose sight of the fact that we are human beings. Why is this important?

22. The main differences of interpreting for adult cardiac surgery and pediatric cardiac surgery. • Matter of Fact • Less detailed explanation of • procedure. • More serious • Softer Tones • More illustration and breaking • down of terms. • Less serious, more relaxing

23. Interpreter Self Care • We often forget to take care of the most important factor in order to interpret. • Mentally prepare • Spiritually prepare • Deep Breathing • Ask for Support • Connection with Peers or • Colleagues • Pamper yourself • Create your own self-care • list Take care of YOU!

25. THE END and…. The Beginning! Lead with your heart!