CPT® Code 33501

The procedure described by CPT® Code 33501 involves the surgical repair of a coronary arteriovenous or arteriocardiac chamber fistula without the use of cardiopulmonary bypass. A coronary arteriovenous fistula is defined as an abnormal connection between a coronary artery and either a systemic or pulmonary vein, which can lead to various complications due to altered blood flow. Similarly, a coronary arteriocardiac chamber fistula refers to an abnormal connection between a coronary artery and a heart chamber, which can also disrupt normal cardiac function. The surgical approach typically requires a median sternotomy, which is an incision made along the sternum to provide access to the heart. During the procedure, the surgeon identifies the feeding coronary artery and the specific site where the fistula connects to the artery. Additionally, the pathway of the fistula and its drainage site into either a vein or a cardiac chamber are carefully mapped out. The absence of cardiopulmonary bypass in this procedure indicates that the heart continues to function normally during the repair, allowing for a more straightforward surgical approach. The closure of the fistula is performed based on its drainage site, either by suturing the venous end or by opening the cardiac chamber to close the drainage site with sutures or a patch. If the feeding vessel is significantly large, the coronary artery may also be incised to facilitate the closure of the fistula. This procedure is critical for restoring normal hemodynamics and preventing potential complications associated with these types of fistulas.