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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.
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The pulmonary valvotomy procedure is indicated for specific congenital heart conditions that impede normal blood flow from the right ventricle to the pulmonary artery. The following conditions warrant this surgical intervention:
The procedure for pulmonary valvotomy via the transventricular approach involves several critical steps to ensure successful intervention. Each step is designed to facilitate access to the pulmonary valve and effectively address the underlying condition.
After the pulmonary valvotomy procedure, patients are typically monitored in a recovery area for any immediate complications. Post-operative care may include pain management, monitoring of vital signs, and assessment of heart function. Patients may require follow-up visits to evaluate the success of the procedure and to ensure that the pulmonary valve is functioning properly. Recovery time can vary based on individual patient factors, but most patients can expect to resume normal activities within a few weeks, contingent upon their overall health and the absence of complications.
| Short Descr | REVISION OF PULMONARY VALVE | Medium Descr | VALVOTOMY PULMONARY VALVE CLSD HEART TRANSVENTR | Long Descr | Valvotomy, pulmonary valve, closed heart; transventricular | 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 | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | 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 |
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| 2021-12-31 | Deleted | Code deleted |
| Pre-1990 | Added | Code added. |
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