CPT® Code 35246

The procedure described by CPT® Code 35246 involves the surgical repair of an intrathoracic blood vessel using a vein graft. This procedure is typically indicated when there is an injury to a blood vessel located within the chest cavity. The term "intrathoracic" refers to the area within the thorax, which houses vital structures such as the heart and lungs. The surgical approach often involves a median sternotomy, which is a common technique where the chest is opened along the sternum to provide access to the heart and surrounding vessels. In some cases, depending on the severity and nature of the injury to the blood vessel, cardiopulmonary bypass may be initiated to maintain blood circulation and oxygenation during the repair process. During the procedure, the injured blood vessel is carefully exposed, and clamps are applied both proximal and distal to the injury site to control any bleeding. The surgeon evaluates the extent of the damage to the blood vessel to determine the appropriate course of action. A vein, often harvested from the saphenous vein in the lower leg, is prepared to serve as a graft. The edges of the damaged blood vessel are debrided to ensure a clean surface for the graft. The prepared vein graft is then meticulously sewn to the ends of the injured blood vessel, allowing for restoration of blood flow. After the clamps are released, the surgical team checks for hemostasis along the suture line to ensure there is no further bleeding. If cardiopulmonary bypass was utilized, the patient is carefully taken off bypass before the overlying tissues are sutured back together in layers. This procedure is specifically coded as CPT® 35246 when performed without the use of cardiopulmonary bypass, distinguishing it from similar procedures that may require this additional support.