CPT® Code 33365

Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; transaortic approach (eg, median sternotomy, mediastinotomy)

Transcatheter aortic valve replacement (TAVR/TAVI) is a minimally invasive procedure designed to replace a narrowed aortic valve that fails to open properly, a condition known as aortic stenosis. This procedure utilizes a catheter-based approach to implant a prosthetic valve, allowing for a less invasive alternative to traditional open-heart surgery. The transaortic approach involves accessing the heart through the aorta, typically via a median sternotomy or mediastinotomy, which provides direct access to the heart and the aortic valve. During the procedure, the heart is exposed, and a small incision is made in the aorta or left ventricle to facilitate the insertion of the catheter carrying the collapsed prosthetic valve. The native aortic valve may be dilated with a balloon catheter to ensure proper placement of the new valve. Once positioned, the prosthetic valve is deployed and secured in place, often using a balloon catheter to ensure it is seated correctly. Following deployment, contrast dye is injected, and angiograms are performed to verify the position and functionality of the newly implanted valve. The procedure concludes with the placement of chest tubes as necessary and the closure of the chest incision, marking the end of the surgical intervention.