CPT® Code 33722

Deleted

The procedure described by CPT® Code 33722 involves the surgical closure of a congenital aortico-left ventricular tunnel (ALVT), which is a rare cardiac defect. In this condition, there is an abnormal connection, or tunnel, that allows blood to flow directly from the left ventricle to the aorta, bypassing the aortic valve. This anomaly typically originates from the right aortic sinus, although it can also arise from the left aortic sinus. The surgical approach to repair this defect usually requires access to the heart through a median sternotomy or thoracotomy, which involves making an incision in the chest to reach the heart. During the procedure, cardiopulmonary bypass is established to take over the function of the heart and lungs, allowing the surgeon to operate on a still and bloodless field. The aorta is cross-clamped to stop blood flow, and cardioplegic arrest is initiated to protect the heart muscle during the repair. A horizontal incision is made in the aorta to access the tunnel, where the surgeon inspects the aortic wall to locate the tunnel's orifice. The opening at the aorta is then closed using sutures or a patch graft, effectively obliterating the tunnel. After the closure, the incision in the aorta is sutured, the aortic clamps are removed, and the patient is gradually weaned off the cardiopulmonary bypass. Finally, chest tubes may be placed to drain any excess fluid, and the chest incision is closed to complete the procedure.