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Pulmonary valvotomy, also known as commissurotomy, is a surgical procedure aimed at addressing issues related to the pulmonary valve, which is situated between the right ventricle of the heart and the pulmonary artery. This valve plays a crucial role in allowing deoxygenated blood to flow from the heart to the lungs for oxygenation. The procedure is primarily indicated for conditions such as pulmonary atresia and pulmonary stenosis. In pulmonary atresia, a congenital heart defect, the pulmonary valve is either absent or fails to open properly, obstructing blood flow from the right ventricle to the pulmonary artery. Conversely, pulmonary stenosis involves a narrowing of the valve orifice, which can also impede blood flow. The surgical approach typically involves a median sternotomy, where the chest is opened to access the heart. During the procedure, the thymus gland may be partially resected to enhance visibility and access to the heart structures. The main pulmonary artery is then incised above the pulmonary valve, allowing the surgeon to inspect the valve. If the valve annulus is determined to be of sufficient size, the surgeon can proceed to open the three commissures of the valve using sharp dissection techniques. Following the valvotomy, the incision in the pulmonary artery is closed, restoring the pathway for blood flow to the lungs.
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The pulmonary valvotomy procedure is indicated for specific cardiac conditions that affect the pulmonary valve. These include:
The procedure of pulmonary valvotomy involves several critical steps to ensure effective treatment of the pulmonary valve conditions. These steps include:
Post-procedure care following a pulmonary valvotomy involves monitoring the patient for any complications and ensuring proper recovery. Patients may require close observation in a cardiac care unit to assess heart function and monitor vital signs. Follow-up imaging may be necessary to evaluate the success of the procedure and the condition of the pulmonary valve. Additionally, patients may need to adhere to specific activity restrictions during the recovery period to promote healing and prevent strain on the heart. The healthcare team will provide guidance on post-operative care, including medication management and follow-up appointments to ensure optimal recovery.
| Short Descr | VLVT PV CLSD HRT VIA P-ART | Medium Descr | VALVOTOMY PULM VALVE CLSD HEART VIA PULM ARTERY | Long Descr | Valvotomy, pulmonary valve, closed heart, via pulmonary artery | 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) | 1 - Co-surgeons could be paid, though supporting documentation is required... | 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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| 2024-12-31 | Deleted | Code Deleted. |
| 2022-01-01 | Changed | Short and Long descriptions changed. |
| 2011-01-01 | Note | Short description changed. |
| 1994-01-01 | Added | Code added. |
| 1991-12-31 | Deleted | Code deleted. |
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