2025 CPT code 33404
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Surgery Feed
Construction of an apical-aortic conduit to bypass the native aortic valve.
Modifiers may apply depending on circumstances; consult the CPT manual for appropriate modifier usage.
Medical necessity is established by demonstrating significant aortic stenosis symptoms (angina, syncope, dyspnea) and high surgical risk that contraindicates traditional open-heart surgery.The procedure should be deemed the most appropriate treatment option based on the patient's clinical condition.
The surgeon's responsibilities include patient preparation, anesthesia administration, incision, exposure of the heart and descending aorta, aortic clamping, conduit creation and placement, pericardium opening, suture placement, cardiopulmonary bypass (if required), myocardium incision, connector insertion, and suture tying to secure the conduit.
In simple words: This surgery creates a new pathway for blood to flow around a blocked aortic valve. The surgeon makes a new channel and valve to allow blood to flow more easily.
Construction of an apical-aortic conduit (AAC), also known as an aortic valve bypass (AVB), is a cardiovascular procedure performed to alleviate symptoms caused by obstructed blood flow from the left ventricle.The procedure involves creating a conduit and valve to bypass the native aortic valve, addressing the obstruction.This may involve cardiopulmonary bypass (CPB).
Example 1: A 70-year-old patient presents with severe aortic stenosis symptoms, including angina and syncope.Due to high surgical risk, the surgeon opts for an apical-aortic conduit construction as a less invasive alternative to open-heart surgery., A 65-year-old patient with a bicuspid aortic valve and severe aortic stenosis undergoes an apical-aortic conduit procedure, with cardiopulmonary bypass used for the procedure., An 80-year-old patient with multiple comorbidities is deemed unsuitable for open-heart aortic valve replacement.An apical-aortic conduit is constructed with minimally invasive techniques, avoiding the need for CPB.
Detailed preoperative assessment, including echocardiogram, cardiac catheterization, and risk stratification; operative report documenting the technique used, including CPB usage (if any); postoperative echocardiogram to assess the conduit function and valve gradients; and any relevant postoperative complications.
** This code encompasses the construction of the apical-aortic conduit, regardless of the specific material or technique utilized.Additional codes may be necessary to report associated procedures, such as cardiopulmonary bypass.
- Payment Status: Active
- Specialties:Cardiothoracic Surgery, Cardiovascular Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center