CPT® Code 93524

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A combined transseptal and retrograde left heart catheterization is a specialized medical procedure utilized primarily for the assessment of mitral valve disease. This technique involves two distinct approaches to access the left side of the heart. Initially, a catheter is introduced into the right atrium, where the intra-atrial septum, the wall separating the right and left atria, is punctured. This allows the catheter to be advanced into the left atrium, facilitating direct access to this chamber of the heart. Concurrently, a retrograde left heart catheterization is performed, which involves accessing the left heart through the arterial system. This is typically achieved via the brachial, axillary, or femoral artery using a percutaneous technique. The skin over the chosen artery is prepared, followed by puncturing the artery with a needle to insert a sheath. A guidewire is then threaded retrograde through the artery, into the aorta, and subsequently into the left ventricle and left atrium. Once the catheter is positioned in the left ventricle, the guidewire is removed, allowing for simultaneous positioning of catheters in both the left atrium and left ventricle. This setup enables the collection of pressure recordings from these chambers. Additionally, angiograms of the aorta, left heart chambers, coronary arteries, arterial conduits, and/or aortocoronary venous bypass grafts may be performed as separate reportable procedures. Upon completion of the catheterization, the catheters are withdrawn, and compression dressings are applied to the access site to ensure hemostasis.