CPT® Code 37140

The CPT® Code 37140 refers to the procedure known as venous anastomosis, specifically an open portocaval anastomosis. This surgical intervention is designed to create a connection between the portal vein and the inferior vena cava, effectively diverting blood flow from the portal circulation. The procedure is commonly indicated in cases where there is increased pressure in the portal vein, often due to conditions such as portal hypertension, which can lead to serious complications like variceal bleeding. The term 'portocaval shunt' is frequently used to describe this operation, highlighting its purpose of shunting blood away from the portal system. The surgical approach involves making an extended incision below the rib cage, allowing the surgeon to access the necessary anatomical structures, including the portal vein and the inferior vena cava. The detailed steps of the procedure involve careful dissection and manipulation of these vessels to ensure a successful anastomosis, which can be performed in either an end-to-side or side-to-side configuration, depending on the specific clinical scenario and the surgeon's preference.