CPT® Code 33771

Repair of transposition of the great arteries with ventricular septal defect and subpulmonary stenosis; with surgical enlargement of ventricular septal defect

The procedure described by CPT® Code 33771 involves the surgical repair of a congenital heart defect known as transposition of the great arteries (TGA), which is characterized by the abnormal positioning of the aorta and pulmonary arteries. In a normal heart, the aorta arises from the left ventricle, while the pulmonary arteries originate from the right ventricle. However, in TGA, the aorta arises from the right ventricle, and the pulmonary arteries arise from the left ventricle. This malformation results in a critical condition where oxygen-poor blood is circulated back to the body without passing through the lungs for oxygenation, while oxygen-rich blood returns to the lungs instead of being delivered to the body. The procedure specifically addresses TGA in conjunction with a ventricular septal defect (VSD) and subpulmonary stenosis. A VSD is an abnormal opening in the ventricular septum, which is the wall dividing the left and right ventricles of the heart, allowing for the mixing of oxygen-rich and oxygen-poor blood. Subpulmonary stenosis refers to a narrowing of the main pulmonary artery just below the pulmonary valve, which can further complicate the condition. The surgical approach for this repair is tailored to the individual patient, as the complexity of TGA often necessitates a unique operative plan. The procedure may involve the enlargement of the VSD to facilitate proper blood flow and the construction of a baffle to redirect blood flow appropriately. Access to the heart is typically achieved through a median sternotomy or thoracotomy, and the procedure may include the resection of the thymus and the harvesting of pericardial tissue for use as a patch graft. Overall, this surgical intervention aims to correct the anatomical defects associated with TGA, thereby restoring normal blood circulation and improving the patient's overall health and quality of life.