CPT® Code 33471

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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.