CPT® Code 33746

Add-On Code

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); each additional intracardiac shunt location (List separately in addition to code for primary procedure)

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 due to various clinical considerations. The TIS procedure is designed to address specific conditions such as hypoplastic left heart syndrome, which may present with an obstructed Fontan fenestration, or right ventricular outflow tract obstruction in patients who have undergone repair for congenital heart disease. Additionally, it can be utilized for patients experiencing complications from earlier surgical procedures, such as narrowed or stenotic baffles resulting from Mustard, Senning, or Warden operations. While many patients undergoing this procedure are typically in the pediatric age group, it is important to note that some complications, like a narrowed Mustard or Senning baffle, can manifest later in adulthood. The procedure involves the use of stent implantation to relieve obstructions, which is a critical step in restoring proper hemodynamics. The process requires careful imaging guidance and diagnostic cardiac catheterization to assess the heart's anatomy and function before proceeding with the stent placement. This comprehensive approach ensures that the procedure is tailored to the individual patient's needs, optimizing outcomes and enhancing the quality of care for those with complex congenital heart conditions.