CPT® Code 0483T

Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; percutaneous approach, including transseptal puncture, when performed

Transcatheter mitral valve implantation/replacement (TMVI) with a prosthetic valve is a minimally invasive procedure designed to address mitral valve disorders, specifically primary (degenerative) and secondary (functional) mitral regurgitation, as well as mitral valve stenosis. This procedure allows for the replacement or implantation of a new valve without the need for open-heart surgery, significantly reducing recovery time and associated risks. The TMVI can be performed through various approaches, including a percutaneous retrograde transapical approach, a percutaneous antegrade transfemoral approach, or through a transthoracic thoracotomy using a transapical technique. The procedure involves accessing the selected vessel percutaneously, advancing a guidewire to the heart, and utilizing imaging techniques such as transesophageal echocardiography and/or angiography to ensure accurate placement of the guidewire. Once the guidewire is positioned correctly, a delivery system catheter is used to place the prosthetic valve over the mitral annulus, which is then deployed under rapid ventricular pacing. This innovative approach allows for effective treatment of mitral valve conditions while minimizing the invasiveness of traditional surgical methods.