CPT® Code 33852

The procedure described by CPT® Code 33852 involves the surgical repair of a hypoplastic or interrupted aortic arch, which is a critical condition affecting the aorta. A hypoplastic aortic arch, also known as diffuse long-segment coarctation, is characterized by a narrowing of the aorta along its entire arch, leading to potential complications in blood flow. An interrupted aortic arch, on the other hand, refers to a complete absence of a segment of the aortic arch, which can severely impact the circulatory system. These conditions often coexist with other congenital cardiac anomalies, such as ventricular septal defect (VSD), patent ductus arteriosus (PDA), aortopulmonary window, and truncus arteriosus, necessitating careful surgical intervention. The surgical approach typically involves making a posterolateral incision to gain access to the aortic arch, followed by mobilization of the ascending aorta, aortic arch, its branches, ductus arteriosus, and descending aorta. During the procedure, it is crucial to protect the recurrent laryngeal and phrenic nerves, and lymphatic vessels are managed with hemoclips. The ductus arteriosus is ligated to prevent blood flow through this vessel. The repair can be performed without cardiopulmonary bypass, utilizing a partial occluding clamp across the aortic arch, or with cardiopulmonary bypass, where cannulation of the aorta and vena cavae is performed to establish bypass and cross-clamp the aorta. The actual repair of the hypoplastic or interrupted segment can be achieved through various techniques, including patch aortoplasty, tube graft replacement, or the use of an autogenous graft, such as a left subclavian artery flap graft. After the repair, the parietal pleura is closed over the graft, and the chest incisions are sutured, with chest tubes placed as necessary to facilitate recovery.