CPT® Code 33775

Repair of transposition of the great arteries, atrial baffle procedure (eg, Mustard or Senning type) with cardiopulmonary bypass; with removal of pulmonary band

The procedure described by CPT® Code 33775 involves the surgical repair of transposition of the great arteries using an atrial baffle technique, which is commonly known as the Mustard or Senning procedure. Transposition of the great arteries is a congenital heart defect 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 this condition, the aorta is connected to the right ventricle, and the pulmonary arteries are connected to the left ventricle. This anatomical arrangement results in a situation 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. This condition is often associated with other cardiac anomalies, such as ventricular septal defect (VSD) and subpulmonary stenosis. VSD is a defect characterized by an abnormal opening in the ventricular septum, allowing 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 complicate the surgical approach. The surgical repair of transposition of the great arteries requires careful planning and may differ significantly from one patient to another, depending on the specific anatomical challenges presented. Access to the heart is typically achieved through a median sternotomy or thoracotomy, and the procedure involves resection of the thymus and incision of the pericardium to harvest a patch graft. Cardiopulmonary bypass is established to facilitate the repair, during which the aorta is cross-clamped, and the right atrium is incised. The atrial septum is resected, and a patch is used to redirect systemic venous blood to the mitral valve orifice, effectively creating a baffle. The procedure may also involve the removal of a previously placed pulmonary band, which is assessed and dilated as necessary. This code is specifically used when the atrial baffle procedure is performed in conjunction with the removal of the pulmonary band, highlighting the complexity and individualized nature of the surgical intervention.