CPT® Code 33978

The procedure described by CPT® Code 33978 involves the removal of a biventricular extracorporeal ventricular assist device (VAD). This device is utilized to support heart function in patients with severe heart failure. The term "extracorporeal" indicates that the device operates outside the body, assisting both the left and right ventricles of the heart. During the procedure, the physician reopens the previous sternal incision to access the chest cavity. The patient is carefully weaned from the VAD to assess whether the heart is functioning adequately on its own. If the left VAD is being removed, the aortic outflow graft is divided, and the site is closed with sutures. Similarly, if the right VAD is being removed, the pulmonary artery inflow graft is divided, and that site is also closed. The inflow cannulas from both ventricles are removed, and the respective sites are closed with purse-string sutures to ensure proper healing. After the removal, the surgical team inspects the suture sites for hemostasis, ensuring there is no excessive bleeding. Additionally, ventricular function is evaluated using transesophageal echocardiography to confirm the heart's performance post-removal. Pacing wires and chest tubes may be placed as necessary before the chest is finally closed. This procedure is critical for patients transitioning from mechanical support back to native heart function.