CPT® Code 33967

The procedure described by CPT® Code 33967 involves the insertion of an intra-aortic balloon assist device (IABP) using a percutaneous approach. This technique is primarily utilized to support patients with severe cardiac conditions by enhancing coronary perfusion and improving cardiac output. The procedure begins with the puncture of the femoral artery, although alternative access points such as the subclavian, axillary, or iliac arteries may also be employed. A J-shaped guidewire is then inserted through the puncture site, advancing it to the level of the aortic arch. Following this, the needle is removed, and the arterial puncture site is enlarged using a dilator and sheath combination to facilitate the passage of the balloon device. The balloon is carefully threaded over the guidewire and advanced through the descending aorta, positioning it just below the left subclavian artery. Once in place, the sheath is removed, and the balloon hub is connected to the balloon pump console, which is crucial for the device's operation. The IABP functions by inflating at the start of diastole, thereby augmenting coronary perfusion, and deflating during systole to assist in the ejection of blood from the left ventricle. This mechanism effectively increases cardiac output while simultaneously reducing the workload and oxygen demands of the left ventricle. The procedure is critical in managing patients with compromised cardiac function, providing temporary support until further interventions can be performed.