CPT® Code 33030

The procedure described by CPT® Code 33030 refers to a pericardiectomy, which is a surgical intervention involving the excision of the pericardium, the fibrous sac surrounding the heart. This procedure can be performed as either a subtotal or complete pericardiectomy and is executed through an open surgical approach. The primary indication for this surgery is to address constrictive pericarditis, a condition characterized by chronic inflammation that leads to the thickening and fibrosis of the pericardial tissue. This thickening can restrict the heart's ability to function properly, resulting in symptoms such as shortness of breath, fatigue, and fluid retention. During the procedure, the surgeon typically employs a median sternotomy or an anterolateral thoracotomy to gain access to the heart. Once the heart is exposed, the surgeon carefully incises the thickened pericardium and begins the dissection process, ensuring the preservation of critical structures such as the right and left phrenic nerves. The excision of the pericardium starts at the ascending aorta and continues around the heart, addressing the lateral and posterior walls of the left ventricle, the pulmonary veins, and the pulmonary artery. The procedure also involves addressing the diaphragmatic surface of the heart and resecting portions of the right ventricle, right atrium, and vena cava as necessary. It is important to note that this specific code is applicable only when the procedure is performed without the use of cardiopulmonary bypass, which is indicated by the use of CPT® Code 33031 when bypass is required.