CPT® Code 33460

Valvectomy of the tricuspid valve is a surgical procedure that involves the removal of the tricuspid valve, which is situated between the right atrium and the right ventricle of the heart. This procedure is typically performed using cardiopulmonary bypass, a technique that temporarily takes over the function of the heart and lungs during surgery, allowing the surgeon to operate on a still and bloodless field. The tricuspid valve may be excised when it is severely damaged, often due to conditions such as infective endocarditis, which is an infection of the heart valves. In cases where there is a significant risk of re-infection, particularly in patients with a history of intravenous drug use, the valve is removed without replacement. The surgical approach usually involves a median sternotomy, which is an incision made along the sternum to access the heart. Once the heart is exposed, cardiopulmonary bypass is initiated, and cardioplegia, a method to induce temporary cardiac arrest, is performed to facilitate the procedure. The surgeon then makes an incision in the right atrium to access and excise the tricuspid valve, including its leaflets, chordae tendineae, and associated papillary muscles. After the valve is removed, the incision in the heart is closed, and the patient is gradually weaned off the cardiopulmonary bypass. Post-operative care may include the placement of chest tubes to manage any fluid accumulation, followed by closure of the chest cavity.