CPT® Code 33413

Replacement, aortic valve; by translocation of autologous pulmonary valve with allograft replacement of pulmonary valve (Ross procedure)

The procedure described by CPT® Code 33413 involves the replacement of the aortic valve through a surgical technique known as the Ross procedure. In this complex operation, the patient's own pulmonary valve is translocated to replace the diseased aortic valve, while a pulmonary valve allograft, sourced from a deceased donor, is used to replace the patient's original pulmonary valve. This innovative approach is primarily indicated for patients suffering from aortic stenosis, a condition characterized by the narrowing of the aortic valve opening, which can lead to significant heart complications if left untreated. The surgical access is achieved by performing a sternotomy, which involves opening the sternum to gain direct access to the heart. To facilitate the procedure and ensure the heart remains functional during surgery, cardiopulmonary bypass is initiated. This allows for the temporary diversion of blood away from the heart and lungs, enabling the surgeon to operate on a still and bloodless field. The aorta is then incised, and the stenotic aortic valve leaflets are carefully excised, with particular attention paid to preserving the coronary arteries. Following the excision, the aortic valve annulus is meticulously prepared to accommodate the translocated pulmonary valve, which is harvested from the patient and sutured into place. Subsequently, the pulmonary valve annulus is prepared for the implantation of the allograft pulmonary valve, which is also sutured into position. Once the procedure is complete, cardiopulmonary bypass is discontinued, and chest tubes may be placed as necessary to facilitate drainage. Finally, the chest is closed, marking the conclusion of the surgical intervention.