CPT® Code 33800

An aortopexy, also known as aortic suspension, is a surgical procedure aimed at decompressing the trachea, particularly in cases of tracheomalacia. Tracheomalacia is characterized by a weakness in the cartilage that supports the trachea, leading to a widening of the posterior membranous wall. This condition can result in the trachea collapsing, which may cause significant respiratory difficulties for the patient. The procedure is performed through a left anterior thoracotomy, which involves making an incision in the chest to access the aorta. During the surgery, the thymus gland is resected, and the apex of the left upper lobe of the lung is retracted to provide better visibility and access to the aorta. Care is taken to avoid dissection of the aorta from the surrounding tissues to minimize complications. A single row of sutures is then placed through the aorta at the aortic arch, ensuring that the sutures penetrate deep enough to include the media and adventitia layers of the aorta. These sutures are subsequently passed to the undersurface of the sternum, anchoring the aorta in place. Alternatively, the sutures may be passed through the sternum to a subcutaneous pocket and tied off. This anchoring technique displaces the aortic arch anteriorly, effectively pulling the anterior wall of the trachea forward, which helps to prevent tracheal collapse and alleviates the associated respiratory issues.