CPT® Code 33745

Transcatheter intracardiac shunt (TIS) creation by stent placement for congenital cardiac anomalies to establish effective intracardiac flow, including all imaging guidance by the proceduralist, when performed, left and right heart diagnostic cardiac catheterization for congenital cardiac anomalies, and target zone angioplasty, when performed (eg, atrial septum, Fontan fenestration, right ventricular outflow tract, Mustard/Senning/Warden baffles); initial intracardiac shunt

Transcatheter intracardiac shunt (TIS) creation by stent placement is a minimally invasive procedure aimed at establishing effective blood flow within the heart for patients with congenital cardiac anomalies. This procedure is particularly relevant when surgical revision of previous interventions is not advisable or feasible. It is commonly performed in cases such as hypoplastic left heart syndrome, where there may be an obstructed Fontan fenestration, or in patients with right ventricular outflow tract obstruction following the repair of congenital heart disease. Additionally, it addresses issues like narrowed or stenotic baffles resulting from earlier surgical procedures, such as the Mustard, Senning, or Warden techniques. While many patients undergoing this procedure are pediatric, some complications, such as a narrowed Mustard or Senning baffle, can manifest later in adulthood. The TIS creation involves the use of stent implantation to relieve obstructions and improve intracardiac flow, which is critical for the overall hemodynamic stability of the patient. The procedure is performed under imaging guidance, ensuring precise placement of the stent and effective management of the congenital heart defect.