CPT® Code 33991

Insertion of ventricular assist device, percutaneous, including radiological supervision and interpretation; left heart, both arterial and venous access, with transseptal puncture

The procedure described by CPT® Code 33991 involves the insertion of a ventricular assist device (VAD) through a percutaneous approach, which means that the device is inserted through the skin rather than through an open surgical procedure. A VAD is a mechanical pump designed to provide circulatory support for patients suffering from heart failure. It is particularly beneficial for patients who have end-stage heart disease and are not suitable candidates for heart transplantation, as well as for those who may have reversible cardiac conditions. The primary function of a VAD is to assist the heart, particularly the left ventricle, in pumping blood effectively throughout the body. In this specific procedure, both arterial and venous access is utilized, which involves inserting cannulas into the femoral artery and femoral vein. The procedure is guided by radiological supervision, ensuring accurate placement of the device. A transseptal puncture is performed to create an opening between the right and left atria, allowing for the proper positioning of the cannula in the left atrium. This setup enables the VAD to withdraw oxygenated blood from the left atrium, which is then propelled through an outflow port and returned to the peripheral arterial system, thereby enhancing blood circulation in patients with compromised heart function.