CPT® Code 33720

The procedure described by CPT® Code 33720 involves the surgical repair of a sinus of Valsalva aneurysm using cardiopulmonary bypass. The sinus of Valsalva refers to the three aortic sinuses located within the pericardium at the uppermost part of the aorta, just above the aortic valve cusps. An aneurysm in this area can arise from either congenital or acquired conditions. Congenital aneurysms are rare and typically affect only one sinus, while acquired aneurysms may develop due to various factors such as Marfan syndrome, syphilitic aortitis, cystic medial necrosis, atherosclerosis, the natural aging process, or trauma to the chest. The surgical approach begins with a median sternotomy to gain access to the heart. Following this, venous and arterial cannulas are inserted to establish cardiopulmonary bypass, allowing the heart to be temporarily stopped and the aorta to be cross-clamped. The procedure involves careful exploration and repair of the aneurysm, which may include the removal of any thrombus present, suturing the aneurysm, and possibly using a patch graft for reinforcement. The aorta is then reconstructed, and the patient is gradually taken off bypass, with appropriate post-operative care initiated.