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Official Description

Valvotomy, pulmonary valve, closed heart, via pulmonary artery

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

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.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The pulmonary valvotomy procedure is indicated for specific cardiac conditions that affect the pulmonary valve. These include:

  • Pulmonary Atresia - A congenital heart defect where the pulmonary valve is either absent or does not open, preventing blood flow from the right ventricle to the lungs.
  • Pulmonary Stenosis - A condition characterized by the narrowing of the pulmonary valve orifice, which restricts blood flow from the heart to the pulmonary artery.

2. Procedure

The procedure of pulmonary valvotomy involves several critical steps to ensure effective treatment of the pulmonary valve conditions. These steps include:

  • Step 1: Median Sternotomy - The surgical approach begins with a median sternotomy, where the chest is opened to provide access to the heart. This approach allows the surgeon to visualize and operate on the heart structures effectively.
  • Step 2: Thymus Resection - To enhance exposure of the heart, the thymus gland is partially resected. This step is essential for providing adequate visibility and access to the pulmonary valve and surrounding structures.
  • Step 3: Incision of the Main Pulmonary Artery - The main pulmonary artery is incised above the level of the pulmonary valve. This incision is crucial for allowing direct access to the valve for inspection and intervention.
  • Step 4: Inspection of the Pulmonary Valve - Once the pulmonary artery is opened, the surgeon inspects the pulmonary valve to assess its condition. This evaluation determines whether the valve annulus is of adequate size for further intervention.
  • Step 5: Commissurotomy - If the valve annulus is deemed sufficient, the surgeon proceeds to open the three commissures of the valve using sharp dissection techniques. This step is vital for alleviating the obstruction caused by atresia or stenosis.
  • Step 6: Closure of the Pulmonary Artery Incision - After the commissurotomy is completed, the incision made in the pulmonary artery is closed, restoring the integrity of the vessel and allowing for normal blood flow to resume.

3. Post-Procedure

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
Date
Action
Notes
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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