Valvuloplasty, mitral valve, with cardiopulmonary bypass
CPT4 code
Name of the Procedure:
Valvuloplasty, Mitral Valve, with Cardiopulmonary Bypass
Summary
Valvuloplasty is a surgical procedure to repair a damaged mitral valve in the heart. During the procedure, cardiopulmonary bypass is used to take over the function of the heart and lungs, allowing the surgeon to repair the valve.
Purpose
Medical Condition: Mitral valve stenosis or regurgitation. Goals: To improve blood flow through the heart, reduce or eliminate symptoms like shortness of breath, and prevent complications such as heart failure.
Indications
- Symptoms of mitral valve stenosis such as fatigue, shortness of breath, or palpitations.
- Signs of mitral valve regurgitation including heart murmur or swelling in the legs.
- Echocardiogram showing significant mitral valve dysfunction.
Preparation
- Fast for at least 8 hours before surgery.
- Adjust or discontinue certain medications as advised by the doctor.
- Pre-procedure diagnostic tests include echocardiogram, chest X-ray, ECG, and blood tests.
Procedure Description
- Anesthesia: General anesthesia is administered.
- Incision: An incision is made in the chest to access the heart.
- Cardiopulmonary Bypass: The heart is connected to a bypass machine that takes over its function.
- Valve Repair: The surgeon repairs the mitral valve using techniques such as removing calcium deposits, reshaping valve parts, or repairing tears.
- Closure: The incision is closed and the patient is gradually taken off bypass.
Tools/Equipment: Cardiopulmonary bypass machine, specialized surgical instruments. Anesthesia: General anesthesia.
Duration
Typically, the procedure takes between 3 to 5 hours.
Setting
This procedure is performed in a hospital operating room, specifically equipped for cardiac surgeries.
Personnel
- Cardiothoracic Surgeon
- Anesthesiologist
- Surgical Nurses
- Perfusionist (operates the cardiopulmonary bypass machine)
Risks and Complications
Common Risks: Infection, bleeding, blood clots. Rare Risks: Stroke, kidney failure, adverse reaction to anesthesia. Possible Complications: Valve dysfunction, arrhythmias, heart attack.
Benefits
- Relief from symptoms such as shortness of breath and fatigue.
- Improved heart function and quality of life.
- Reduced risk of complications like heart failure.
Recovery
- Hospital Stay: Usually 5 to 7 days.
- Post-procedure Care: Pain management, wound care, gradually increasing activity.
- Recovery Time: 6 to 12 weeks with possible restrictions on strenuous activities.
- Follow-up: Regular check-ups, echocardiograms, and potential cardiac rehabilitation.
Alternatives
- Medications: For symptom management but do not repair the valve.
- Balloon Valvuloplasty: A less invasive procedure, suitable for some patients.
- Valve Replacement: If repair is not feasible.
Pros and Cons: Medications manage symptoms short-term. Balloon valvuloplasty is less invasive but may not be as effective long-term. Valve replacement is more invasive but can completely resolve severe cases.
Patient Experience
During: No awareness or pain due to general anesthesia. After: Pain at the incision site, soreness, and limited activity. Pain management and comfort measures will be applied.
- Emotional Support: Available through counseling and support groups if needed.
The information provided above gives an overview of what patients can expect before, during, and after a valvuloplasty procedure, along with the associated risks and benefits.