CPT® Code 33620

The application of right and left pulmonary artery bands is a surgical procedure aimed at managing excessive pulmonary blood flow, which can result in hypertrophy of the pulmonary vasculature and potentially lead to irreversible pulmonary hypertension. This procedure is particularly relevant in the context of certain congenital cardiac anomalies, such as hypoplastic left heart syndrome. The banding of the pulmonary arteries serves as an initial intervention, preparing the heart for subsequent definitive repairs of the cardiac defect. The procedure is typically performed using a hybrid approach, which may involve a staged surgical strategy to optimize patient outcomes. Access to the heart is achieved through a limited left anterior or lateral thoracotomy, although a median sternotomy may also be utilized in some cases. During the procedure, the pericardium is incised, and the thymus gland is retracted to provide visibility and access to the aorta and pulmonary arteries. An adjustable band is then prepared, marked for the estimated circumference, and placed around the targeted pulmonary artery. The band is secured using a snare, and adjustments are made to ensure that the pulmonary artery pressure distal to the band remains within normal limits. Finally, the band is sutured to the arterial adventitia to prevent any migration, and this process is repeated for the contralateral pulmonary artery, ensuring balanced management of blood flow to both lungs.