Division of aberrant vessel (vascular ring); with reanastomosis
CPT4 code
Name of the Procedure:
Division of aberrant vessel (vascular ring) with reanastomosis.
Summary
This surgical procedure involves cutting and rearranging an abnormal blood vessel that forms a vascular ring, which can compress the trachea and esophagus. The vessel is then reconnected to ensure proper blood flow.
Purpose
The procedure is performed to relieve compression caused by a vascular ring, which can obstruct the airway and esophagus, leading to breathing and swallowing difficulties. The goal is to improve these functions and alleviate associated symptoms.
Indications
- Difficulty breathing or stridor (noisy breathing)
- Swallowing problems or choking
- Recurrent respiratory infections
- Diagnosis of a vascular ring through imaging studies
- Significant compression of the trachea or esophagus visible on imaging
Preparation
- Fasting for 6-8 hours before the procedure
- Adjusting or discontinuing certain medications, as advised by the physician
- Preoperative imaging tests, such as an MRI or CT scan, to locate the aberrant vessel
- Routine blood work and possibly a pre-surgical consultation with an anesthesiologist
Procedure Description
- The patient is placed under general anesthesia.
- A small incision is made in the chest.
- The surgeon identifies and isolates the aberrant vessel forming the vascular ring.
- The vessel is cut to release the compression.
- The severed ends of the vessel are reconnected (reanastomosed) to maintain proper blood flow.
- The incision is closed, and the patient is moved to recovery.
Duration
The procedure typically takes around 2-4 hours, depending on the complexity of the case.
Setting
The surgery is performed in a hospital operating room equipped with advanced surgical tools and monitoring equipment.
Personnel
- Cardiothoracic surgeon
- Surgical nurses
- Anesthesiologist
- Operating room technicians
Risks and Complications
- Infection
- Bleeding
- Anesthetic complications
- Damage to surrounding structures, such as the trachea or esophagus
- Blood clots
- Recurrent symptoms if the reanastomosis does not hold properly
Benefits
- Relief from breathing difficulties and noisy breathing
- Improved swallowing and reduced choking episodes
- Decreased frequency of respiratory infections
- Enhanced overall quality of life soon after recovery
Recovery
- Initial hospital stay of 5-7 days to monitor recovery
- Pain management through prescribed medications
- Limited physical activity for a few weeks post-surgery
- Follow-up visits with the surgeon to ensure proper healing
- Gradual return to normal activities within 4-6 weeks
Alternatives
- Watchful waiting for mild cases without severe symptoms
- Non-surgical treatments for managing symptoms, though these may not address the root cause
- Advantages: Avoids surgical risks and complications
- Disadvantages: May not provide long-term relief or improvement in severe cases
Patient Experience
During the procedure, the patient will be under general anesthesia and will not feel pain. Postoperatively, there may be some discomfort or pain at the incision site, managed with medications. The patient might experience minor difficulties in breathing or swallowing initially, which will improve as healing progresses.
Pain management and comfort measures, such as prescribed analgesics and supportive care, will be provided to ensure a smooth recovery.