CPT® Code 33608

Repair of complex cardiac anomaly other than pulmonary atresia with ventricular septal defect by construction or replacement of conduit from right or left ventricle to pulmonary artery

The procedure described by CPT® Code 33608 involves the repair of a complex cardiac anomaly, specifically excluding pulmonary atresia with ventricular septal defect. This surgical intervention is aimed at constructing or replacing a conduit that connects either the right or left ventricle to the pulmonary artery. A conduit, in this context, refers to a tubular graft that can be fabricated from synthetic materials or derived from cadaver donor aortic or arterial grafts. The conduit may be designed with or without a valve, depending on the specific requirements of the patient's condition. This procedure is particularly indicated for addressing ventricular outflow tract anomalies or complications that arise from previous cardiac surgeries, which may lead to obstructions in the outflow tract of the right or left ventricle. The surgical approach typically involves a median sternotomy, which provides access to the heart. During the procedure, cardiopulmonary bypass is established to maintain circulation and oxygenation while the heart is temporarily stopped, and cardioplegia is initiated to protect the heart muscle. The surgeon then incises the right or left ventricle to examine the outflow tract, followed by the suturing of the conduit to the ventricle at the site of ventriculotomy. Subsequently, the main pulmonary artery is incised, and the conduit is sutured to it, ensuring proper connection for blood flow. After completing the necessary repairs, the heart is closed, and cardiopulmonary bypass is discontinued. Finally, chest tubes are placed to facilitate drainage, and the chest incision is closed to complete the procedure.