CPT® Code 33470

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Pulmonary valvotomy, also known as commissurotomy, is a surgical procedure aimed at addressing conditions such as pulmonary atresia and pulmonary stenosis. The pulmonary valve is a critical structure located between the right ventricle of the heart and the pulmonary artery, playing a vital role in regulating blood flow from the heart to the lungs. In cases of pulmonary atresia, a congenital heart defect, the pulmonary valve is either absent or malformed, preventing proper blood flow. Conversely, pulmonary stenosis refers to a narrowing of the valve orifice, which restricts blood flow and can lead to increased pressure within the heart. The procedure is typically performed through a median sternotomy, which involves making an incision along the breastbone to access the heart. During the operation, the thymus gland may be partially resected to enhance visibility and access to the heart structures. The transventricular approach utilized in CPT® Code 33470 involves placing a purse-string suture in the right ventricular wall below the pulmonary valve, allowing for a small incision to be made. This technique enables the surgeon to introduce a clamp to tear the fused commissures of the valve, followed by the use of dilators to expand the valve orifice to an adequate size, ensuring improved blood flow from the heart to the lungs.