CPT® Code 33925

The procedure described by CPT® Code 33925 involves the surgical repair of pulmonary artery arborization anomalies through a technique known as unifocalization, which is performed without the use of cardiopulmonary bypass. Arborization anomalies are often associated with congenital heart defects, particularly pulmonary atresia and ventricular septal defects (VSD). These anomalies manifest as collateral arteries, commonly referred to as major aorto-pulmonary collateral arteries (MAPCAs), which serve as alternative pathways for blood flow between the aorta and the pulmonary arteries. The goal of the unifocalization procedure is to connect these collateral arteries and create a more centralized confluence, thereby improving blood flow to the lungs. The surgical approach typically involves either a median sternotomy or a thoracotomy, allowing access to the heart. In cases where cardiopulmonary bypass is not utilized, the procedure focuses on mobilizing and connecting the MAPCAs directly to the pulmonary artery. This is a critical first step in a staged repair process for patients with multiple cardiac anomalies. The careful dissection and mobilization of the collateral arteries, along with the management of branch vessels, are essential components of the procedure to ensure proper anastomosis and minimize complications. The use of this code is specifically indicated when the procedure is performed without the assistance of cardiopulmonary bypass, distinguishing it from similar procedures that may require such support.