CPT® Code 0258T

Transthoracic cardiac exposure (eg, sternotomy, thoracotomy, subxiphoid) for catheter-delivered aortic valve replacement; without cardiopulmonary bypass

The procedure described by CPT® Code 0258T involves the replacement of a stenotic aortic heart valve with a prosthetic valve, utilizing a catheter-based approach through transthoracic cardiac exposure. This exposure can be achieved via several surgical techniques, including sternotomy, thoracotomy, or subxiphoid incision. During the procedure, the pericardium, which is the fibrous sac surrounding the heart, is incised to allow access to the heart. Notably, this specific code pertains to cases where the procedure is performed without the use of cardiopulmonary bypass, which is a technique that temporarily takes over the function of the heart and lungs during surgery. In such cases, epicardial pacing wires are placed on the left ventricle to facilitate pacing of the heart while the valve is being delivered. This method is crucial for ensuring that the heart maintains an appropriate rhythm during the procedure, particularly when bypass is not utilized. The overall goal of this intervention is to effectively replace the dysfunctional aortic valve, thereby improving blood flow and alleviating symptoms associated with aortic stenosis.