CPT® Code 33993

Repositioning of percutaneous right or left heart ventricular assist device with imaging guidance at separate and distinct session from insertion

A ventricular assist device (VAD) is a sophisticated mechanical pump designed to provide circulatory support for patients suffering from heart failure. These devices are primarily utilized to assist the heart's left ventricle, which is responsible for pumping oxygenated blood to the body. In certain clinical scenarios, the positioning of the VAD may require adjustment, particularly if the device has advanced too far into the heart, resulting in both the inflow and outflow areas being fully situated within the left ventricle. In such instances, a physician may need to reposition the device by carefully pulling it back to ensure optimal function. For right heart ventricular assist devices, the repositioning process involves adjusting the cannulas under imaging guidance. This is crucial to confirm that the inflow cannula is correctly positioned with its tip located in the right atrium, while the outflow cannula must be accurately placed within the pulmonary artery. The repositioning procedure is typically conducted under fluoroscopic guidance, which allows for real-time imaging to ensure precise placement. Additionally, some VADs are equipped with a repositioning sheath that facilitates bedside adjustments, enhancing the flexibility and efficiency of the repositioning process.