CPT® Code 35560

The procedure described by CPT® Code 35560 refers to a surgical intervention known as aortorenal bypass grafting using a vein. This complex operation is performed to create a new pathway for blood flow from the aorta to the renal artery, which may be obstructed due to various conditions. The surgery begins with an incision in the upper abdomen, allowing access to the abdominal aorta and the renal artery. The lesser omentum, a fold of peritoneum, is opened to facilitate the dissection of the diaphragmatic crura, which are the muscular structures that support the diaphragm. Once the upper abdominal aorta is exposed, the renal artery is carefully dissected free from surrounding tissues to prepare for the grafting procedure. A vein graft, often harvested from the saphenous vein in the leg, is utilized to bypass the obstructed segment of the renal artery. The harvesting process involves making an incision over the saphenous vein, dissecting the soft tissue away, and ligating any branches before removing the vein segment. The surgical team then places a side-biting clamp on the aorta at the base of the renal artery to control blood flow during the grafting. An incision is made in the aorta, and the harvested vein graft is sutured to it. Subsequently, the renal artery is incised beyond the area of obstruction, and the vein graft is sutured to the renal artery, restoring blood flow. The procedure concludes with the release of the vascular clamp and a thorough check of the suture lines to ensure there is no bleeding, thereby promoting hemostasis.