CPT® Code 35697

Reimplantation, visceral artery to infrarenal aortic prosthesis, each artery (List separately in addition to code for primary procedure)

The procedure described by CPT® Code 35697 involves the reimplantation of a visceral artery to an infrarenal aortic prosthesis. This surgical intervention is typically performed during a separate open procedure on the aorta, where the physician meticulously dissects the visceral vessel from the surrounding soft tissue to prepare it for reattachment. A critical component of this procedure is the creation of a patch from a button of aortic tissue, which is cut from the origin of the visceral vessel. This patch, often referred to as a Carrel patch, is essential for ensuring a secure and effective reattachment to the aortic prosthesis. The smoothness and patency of the button are carefully examined to confirm its suitability for the procedure. Once the patch is prepared, the site on the aortic prosthesis where the reimplantation will occur is clamped using a side-biting clamp. A corresponding hole is then created in the aortic prosthesis to match the size of the aortic button. The Carrel patch is sutured into this hole, establishing a new connection between the visceral artery and the prosthesis. After the clamps are removed, the anastomosis site is thoroughly checked for any signs of leakage, and additional sutures may be applied as necessary to ensure the integrity of the connection. This procedure is primarily aimed at restoring blood supply to the colon by reimplanting the inferior mesenteric artery into the infrarenal aortic prosthesis, although it can also be performed on other visceral arteries. Each instance of visceral artery reimplantation is reported separately using the code 35697.