CPT® Code 33973

The procedure described by CPT® Code 33973 involves the insertion of an intra-aortic balloon assist device (IABP) through the ascending aorta, a critical intervention often performed in patients experiencing severe cardiac conditions. The aorta, which is the main artery supplying blood to the body, is accessed through a surgical procedure known as median sternotomy, where the chest is opened to provide direct access to the heart and major blood vessels. During this procedure, a side-biting clamp is applied to the ascending aorta to control blood flow, allowing for a safe incision in the aorta. The IABP is introduced using the Seldinger technique, a method that involves the use of a guide wire to facilitate the placement of the catheter. The IABP is positioned distal to the left subclavian artery, which is crucial for ensuring that the device functions effectively to augment coronary perfusion. The device is secured in place with purse-string sutures, which help to prevent any leakage of blood around the catheter. In some cases, a synthetic graft may be used to create an end-to-side anastomosis with the aorta, providing an alternative pathway for the IABP. Once the IABP is in place, it is connected to a balloon pump console, which controls the inflation and deflation of the balloon. This inflation occurs at the start of diastole, enhancing blood flow to the coronary arteries, while deflation occurs during systole, assisting the heart in ejecting blood and improving overall cardiac output. The procedure is designed to reduce the workload on the left ventricle, thereby decreasing its oxygen demand. The subsequent removal of the IABP, as described in CPT® Code 33974, involves careful closure of the aorta and management of the surgical site to ensure patient safety and recovery.