CPT® Code 33621

The procedure described by CPT® Code 33621 involves the transthoracic insertion of a catheter specifically for the placement of a stent, followed by the removal of the catheter and closure of the incision. This procedure is part of a hybrid approach, often referred to as stage 1, which is utilized in the management of certain congenital cardiac anomalies, particularly hypoplastic left heart syndrome. In this context, the term "transthoracic" indicates that the catheter is inserted through the chest wall, allowing direct access to the heart and associated structures. The stent placement is crucial as it serves as a temporary conduit, facilitating blood flow from the pulmonary artery to the aorta, thereby aiding in the stabilization of the patient until a more definitive surgical repair can be performed. The procedure typically requires careful surgical exposure of the heart, which may be achieved through a limited left anterior or lateral thoracotomy, or, in some cases, a median sternotomy. This approach allows the surgeon to access the pericardium, which is then incised, and the thymus gland is retracted to provide a clear view of the aorta and pulmonary arteries. The insertion of the catheter and deployment of the stent are performed with precision to ensure proper positioning and functionality, ultimately contributing to the overall management of complex cardiac conditions.