CPT® Code 33866

Add-On Code

Aortic hemiarch graft including isolation and control of the arch vessels, beveled open distal aortic anastomosis extending under one or more of the arch vessels, and total circulatory arrest or isolated cerebral perfusion (List separately in addition to code for primary procedure)

The aortic hemiarch is a critical segment of the aorta, specifically the portion from which the innominate artery, left common carotid artery (LCCA), and left subclavian artery (LSCA) originate. This area is essential for supplying blood to the brain and upper body. Aortic hemiarch grafting is a surgical procedure performed to repair this segment, particularly when an aneurysm extends into the aortic hemiarch, necessitating intervention alongside ascending aorta repair. The procedure involves the isolation and control of the arch vessels to ensure a safe surgical environment. During the operation, total circulatory arrest or isolated cerebral perfusion techniques are employed to maintain blood flow to the brain while the graft is placed. This is crucial for preventing neurological damage during the repair process. The surgical technique includes creating a beveled open distal aortic anastomosis, which is the connection between the graft and the aorta, extending under one or more of the arch vessels. This procedure is typically performed in conjunction with other cardiac surgeries and is billed separately from the primary procedure, reflecting its complexity and the specialized care required for successful outcomes.