CPT® Code 33858

The CPT® Code 33858 refers to a surgical procedure involving the repair of an ascending aorta graft, specifically performed with the assistance of cardiopulmonary bypass. This procedure is indicated for patients suffering from aortic dissection, a serious condition where the inner layer of the aorta tears, leading to potential life-threatening complications. The procedure begins with a median sternotomy, which is a surgical incision made through the sternum to provide access to the heart and ascending aorta. Once access is achieved, cardiopulmonary bypass is initiated to take over the function of the heart and lungs during the surgery, allowing the surgeon to operate on a still and bloodless field. The ascending aorta is then cross-clamped to isolate the area of repair. Following this, the aorta is transected above the cross-clamp, and a graft is secured to the aortic annulus using sub-annular stitches. If necessary, valve suspension is performed to ensure the proper positioning and function of the aortic valve, which is critical for maintaining effective blood flow. The procedure concludes with the reattachment of the graft to the remaining normal ascending aorta, followed by the careful removal of air from the heart, reperfusion, and closure of the chest. This complex surgical intervention is essential for restoring normal aortic function and preventing further complications associated with aortic dissection.