CPT® Code 33977

The procedure described by CPT® Code 33977 involves the removal of an extracorporeal ventricular assist device (VAD) specifically for a single ventricle. This surgical intervention is typically performed when the patient's heart function has improved sufficiently to no longer require mechanical support. The process begins with the reopening of a previous sternal incision, allowing access to the chest cavity. The physician carefully weans the patient from the VAD to assess the adequacy of heart function before proceeding with the removal. Depending on whether the VAD is positioned on the left or right ventricle, specific steps are taken to safely detach the device. For a left VAD, the aortic outflow graft is divided, and the site is sutured closed, while the inflow cannula is removed from the left ventricle and the site is closed with purse-string sutures. Conversely, if a right VAD is being removed, the pulmonary artery inflow graft is divided, and the outflow cannula is removed from the right ventricle, with the cannula site also closed using purse-string sutures. Throughout the procedure, the surgeon inspects the suture sites to ensure hemostasis, and ventricular function is evaluated using transesophageal echocardiography. Additional measures, such as placing pacing wires and chest tubes, may be taken as necessary before finally closing the chest. This code is specifically utilized when a single ventricle VAD is removed, distinguishing it from CPT® Code 33978, which is used for the removal of a biventricular device.