CPT® Code 33802

The procedure described by CPT® Code 33802 involves the division of an aberrant vessel as a means to repair a vascular ring. A vascular ring is a complex anatomical condition characterized by one or more abnormal blood vessels that encircle and compress vital structures such as the trachea and esophagus. This compression can lead to significant respiratory and swallowing difficulties. The most prevalent forms of vascular rings include the double aortic arch and the right aortic arch with an anomalous left subclavian artery. In a typical aortic arch, there is a single branch that curves to the left after exiting the heart. However, in a double aortic arch, two branches encircle the trachea and esophagus before merging into a single descending aorta, which is responsible for supplying blood to the torso and lower extremities. Conversely, a right aortic arch configuration results in the left subclavian artery wrapping around the trachea, potentially leading to complications such as Kommerell's diverticulum, an aneurysm of the left subclavian artery wall. The presence of the ligamentum arteriosum, which connects the pulmonary artery to the anomalous left subclavian artery, can further constrict the trachea. The surgical intervention involves a left thoracotomy, where the surgeon carefully dissects the soft tissues and evaluates the vascular structures, ultimately clamping and dividing the smaller arch to alleviate the compression. This procedure is critical for restoring normal blood flow and relieving the symptoms associated with vascular rings.