CPT® Code 33690

Pulmonary artery banding (PAB) is a surgical procedure utilized primarily as an initial treatment for congenital heart defects characterized by left-to-right shunting and excessive pulmonary blood flow. This intervention aims to mitigate the complications associated with pulmonary overcirculation, which can lead to hypertrophy of the pulmonary vasculature and the development of irreversible pulmonary hypertension. The procedure involves accessing the pulmonary artery through surgical techniques such as an anterior left thoracotomy, typically performed in the second or third intercostal space, or via a median sternotomy. During the operation, the pericardium is incised, allowing for the retraction of the thymus and exposure of the main pulmonary artery and aorta. The surgeon estimates the necessary circumference for the band and selects an appropriate site for placement on the mid-portion of the main pulmonary artery. The band is then carefully positioned and secured to regulate blood flow, ensuring that pulmonary artery pressures, systemic blood pressure, and arterial oxygen saturation are maintained within acceptable ranges. This procedure is critical in managing specific congenital cardiac conditions and plays a significant role in preventing further complications related to pulmonary circulation.