CPT® Code 33416

Ventriculomyotomy, also known as ventriculomyectomy, is a surgical procedure specifically indicated for the treatment of idiopathic hypertrophic subaortic stenosis, which is often referred to as hypertrophic cardiomyopathy. This condition is characterized by an abnormal thickening of the heart muscle, particularly affecting the left ventricle, leading to asymmetric enlargement. The most significant manifestation of this condition is the obstruction of blood flow from the left ventricle to the aorta, which occurs below the aortic valve. Importantly, both the aortic valve and the left ventricular-aortic junction remain of normal size, indicating that the stenosis is not due to a structural defect in these areas but rather the result of excessive muscle tissue growth, primarily in the interventricular septum. The surgical intervention involves either incising the heart muscle (ventriculomyotomy) or excising a portion of the muscle (ventriculomyectomy) to alleviate the obstruction. Access to the heart is typically achieved through a median sternotomy, which allows the surgeon to reach the heart effectively. To ensure that the heart continues to function properly during the procedure, cardiopulmonary bypass is initiated. The left ventricle is accessed through an incision made in the aorta (aortotomy), allowing the surgeon to make one or more deep incisions into the hypertrophied heart muscle. The goal of these incisions is to reduce the outflow obstruction by removing small amounts of myocardial tissue until the pressure gradients are normalized. Once the procedure is completed, the aortic incision is closed, cardiopulmonary bypass is discontinued, and the chest incision is sutured closed, marking the end of the surgical intervention.