CPT® Code 33864

Ascending aorta graft, with cardiopulmonary bypass with valve suspension, with coronary reconstruction and valve-sparing aortic root remodeling (eg, David Procedure, Yacoub Procedure)

The CPT® Code 33864 refers to a complex surgical procedure involving the ascending aorta, specifically designed to address thoracic aortic aneurysms that also affect the aortic root. This procedure is performed under cardiopulmonary bypass, which is a technique that temporarily takes over the function of the heart and lungs during surgery, allowing for a bloodless surgical field and the ability to stop the heart for precise surgical manipulation. The procedure includes several critical components: the use of an ascending aorta graft, suspension of the aortic valve, reconstruction of the coronary arteries, and remodeling of the aortic root while preserving the aortic valve. This intricate approach is commonly known as the David Procedure or Yacoub Procedure, named after the surgeons who developed these techniques. The surgery typically begins with a standard median sternotomy, which involves making an incision down the middle of the chest to access the heart and aorta. The procedure is highly specialized and requires careful evaluation and manipulation of the aortic root and valve, ensuring that the aortic annulus is appropriately sized and that the aortic valve is reimplanted correctly to maintain its function. Overall, this procedure aims to repair the aneurysm while preserving the integrity and function of the aortic valve and coronary arteries, thus enhancing patient outcomes and reducing the risk of complications associated with aortic surgery.