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Code deleted. See 33390, 33391.

Official Description

Valvuloplasty, aortic valve; open, with inflow occlusion

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

An open aortic valvuloplasty is a surgical procedure aimed at correcting a narrowed or stenosed aortic valve, which is crucial for proper blood flow from the heart to the rest of the body. The aortic valve typically consists of three leaflets or cusps, and any malformation or narrowing can significantly impact cardiac function. This procedure can be performed using two primary methods: with cardiopulmonary bypass or with inflow occlusion. In cases where cardiopulmonary bypass is utilized, the patient's blood is rerouted through a heart-lung machine, allowing the surgeon to operate on a still and bloodless heart. Alternatively, inflow occlusion involves temporarily stopping venous blood flow to the heart by occluding the superior and inferior vena cava, which allows the heart to empty of blood and provides a clear surgical field. Access to the heart is achieved through a median sternotomy, where the sternum is opened, or through a thoracotomy, which involves opening the chest wall. The procedure entails cross-clamping and incising the aorta, followed by dilation of the valve or division of scar tissue, ultimately restoring normal function to the aortic valve. After the procedure, the aorta is closed, and the method of blood flow management is terminated, with chest tubes placed as necessary to facilitate recovery.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The open aortic valvuloplasty procedure is indicated for patients experiencing aortic valve stenosis or narrowing, which can lead to significant cardiovascular complications. The following conditions may warrant this surgical intervention:

  • Aortic Valve Stenosis - A condition characterized by the narrowing of the aortic valve, impeding blood flow from the heart to the aorta and subsequently to the rest of the body.
  • Malformation of the Aortic Valve - Instances where the aortic valve has fewer than three cusps, such as a unicuspid or bicuspid valve, which can lead to functional impairment and require surgical correction.

2. Procedure

The open aortic valvuloplasty procedure involves several critical steps to ensure successful intervention on the aortic valve. The following outlines the procedural steps:

  • Step 1: Patient Preparation - The patient is positioned appropriately, and anesthesia is administered. Preoperative assessments are conducted to ensure the patient is stable for surgery.
  • Step 2: Accessing the Heart - The surgeon gains access to the heart through a median sternotomy or thoracotomy, allowing for direct visualization and manipulation of the heart structures.
  • Step 3: Initiating Blood Flow Management - Depending on the chosen method, either cardiopulmonary bypass is initiated by cannulating the aorta and the superior and inferior vena cava, or inflow occlusion is performed by occluding the vena cavae with snares to temporarily halt venous blood flow.
  • Step 4: Cross-Clamping the Aorta - The aorta is cross-clamped to prevent blood flow during the procedure, followed by an incision in the aorta to access the aortic valve.
  • Step 5: Valve Dilation or Scar Tissue Division - The aortic valve is then dilated to relieve stenosis, or any scar tissue present is divided to restore normal function.
  • Step 6: Closing the Aorta - After the necessary interventions on the valve are completed, the incision in the aorta is meticulously closed to ensure proper sealing and prevent leakage.
  • Step 7: Terminating Blood Flow Management - The method of blood flow management, whether cardiopulmonary bypass or inflow occlusion, is then terminated, allowing blood to flow back into the heart.
  • Step 8: Closing Incisions - Finally, the surgical incisions in the chest are closed, and chest tubes may be placed as needed to facilitate drainage and recovery.

3. Post-Procedure

Post-procedure care for patients who have undergone open aortic valvuloplasty includes monitoring for any complications, managing pain, and ensuring proper recovery. Patients are typically observed in a recovery area before being transferred to a hospital room. Chest tubes, if placed, are monitored for drainage and removed when appropriate. Patients may require medications to manage pain and prevent infection. Follow-up appointments are essential to assess the function of the aortic valve and overall cardiac health. Rehabilitation may also be recommended to aid in recovery and improve cardiovascular fitness.

Short Descr VALVULOPLASTY OPEN
Medium Descr VALVULOPLASTY AORTIC VALVE OPEN W/INFLOW OCCLUS
Long Descr Valvuloplasty, aortic valve; open, with inflow occlusion
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 9 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Inpatient Procedures, not paid under OPPS
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P2F - Major procedure, cardiovascular-Other
MUE Not applicable/unspecified.
CCS Clinical Classification 43 - Heart valve procedures
Date
Action
Notes
2016-12-31 Deleted Code deleted. See 33390, 33391.
2011-01-01 Changed Short description changed.
1994-01-01 Added First appearance in code book in 1994.
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