2025 CPT code 33820
Effective Date: N/A Revision Date: N/A Surgery - Cardiovascular System Feed
Repair of patent ductus arteriosus by ligation.
Medical necessity for surgical ligation of PDA is established by documentation of significant hemodynamically significant shunting, pulmonary hypertension, or symptoms of congestive heart failure. Prophylactic closure in asymptomatic patients may be justified to prevent future complications like infective endocarditis, especially if the patient has other risk factors.
The surgeon makes a small incision on the left side of the chest between the ribs to access the heart and locate the patent ductus arteriosus (PDA). After identifying the PDA, the surgeon ligates, or closes, the ductus using sutures to tie off the opening. The incision is then closed, and chest tubes or drainage tubes may be placed before the incision is dressed. Post-operatively, the patient's heart rate and rhythm, blood pressure, temperature, and breathing rate are closely monitored in the intensive care unit.
In simple words: This procedure closes an abnormal opening between two major blood vessels near the heart. The opening, called a patent ductus arteriosus, is present before birth but usually closes shortly afterward. If it doesn't close, this surgery is performed to close it with stitches or a clip. The surgery is done through a small incision in the chest, and the patient will be monitored closely afterwards.
This procedure involves the surgical closure of a patent ductus arteriosus (PDA) through ligation. A PDA is a persistent opening between the aorta and the pulmonary artery, which normally closes shortly after birth. Under general anesthesia, the surgeon accesses the PDA through a small incision in the left side of the chest between the ribs. The open ductus is then closed using sutures (ligation) or a surgical clip. Post-operatively, the patient is monitored in an intensive care unit until stable.
Example 1: A 2-month-old infant presents with a PDA causing excessive blood flow to the lungs and symptoms of congestive heart failure. Medical management with indomethacin has been unsuccessful. Surgical ligation of the PDA is performed., A premature infant weighing 1.5 kg is diagnosed with a PDA. Due to the infant's size and condition, catheter-based closure is deemed too risky. Surgical ligation is performed to close the PDA., A 6-month-old infant is found to have a small, asymptomatic PDA during a routine checkup. To prevent future complications such as infective endocarditis, elective surgical ligation is recommended.
Documentation should include operative report detailing the surgical approach (sternotomy or thoracotomy), size and location of the PDA, method of closure (suture ligation or clip), and any intraoperative or postoperative complications. Preoperative imaging studies (e.g., echocardiogram) confirming the diagnosis of PDA and any associated cardiac abnormalities should also be documented. Postoperative notes should detail the patient's recovery, including vital signs, respiratory status, and any complications.
- Specialties:Pediatric Cardiovascular Surgery, Cardiothoracic Surgery
- Place of Service:Inpatient Hospital