2025 CPT code 33413
Effective Date: N/A Surgery - Cardiovascular System Feed
Translocation of autologous pulmonary valve to aortic position with allograft replacement of pulmonary valve (Ross procedure).
Medical necessity is established by documentation of severe aortic valve disease (stenosis or regurgitation) causing significant symptoms or impacting cardiac function. The decision to perform a Ross procedure should be based on patient-specific factors, such as age, comorbidities, and lifestyle.
The surgeon performs the Ross procedure under general anesthesia and cardiopulmonary bypass (CPB). The chest is opened via sternotomy, and the pericardium is incised. The damaged aortic valve is removed, and the pulmonary valve is harvested and placed in the aortic position. A donor pulmonary valve (allograft) is then implanted to replace the patient's own pulmonary valve. The chest incision is closed, and the patient is weaned off CPB.
In simple words: This is a heart surgery where the surgeon replaces the damaged aortic valve with the patient's own healthy pulmonary valve. The pulmonary valve is then replaced with a donated valve. This procedure is known as the Ross Procedure.
Replacement of the aortic valve with the patient's own pulmonary valve (autograft), and replacement of the pulmonary valve with a donor valve (allograft). This complex procedure, known as the Ross procedure, is performed to address aortic valve stenosis or regurgitation.
Example 1: A 25-year-old patient with severe aortic stenosis and a desire to avoid lifelong anticoagulation therapy undergoes a Ross procedure., A 40-year-old patient with aortic regurgitation and a history of endocarditis undergoes a Ross procedure to reduce the risk of future infections., A child with a congenital aortic valve defect undergoes a Ross procedure to provide a growing valve option.
Documentation should include the preoperative evaluation, operative report detailing the procedure (including valve sizes, bypass times, and any complications), and postoperative care. Justification for the Ross procedure over other valve replacement options should also be documented.
- Specialties:Cardiothoracic Surgery, Cardiac Surgery
- Place of Service:Inpatient Hospital