93567 Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for supravalvular aortography (List separately in addition to code for primary procedure)

Name of the Procedure:

Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for supravalvular aortography

Summary

In this procedure, a special dye is injected into the area above the aortic valve during a cardiac catheterization to visualize the blood flow and structure using imaging techniques. This helps in identifying and diagnosing issues in the blood vessels and heart.

Purpose

The procedure aims to visualize the blood flow in the aorta and its branches to diagnose conditions like blockages, aneurysms, or congenital abnormalities. It provides detailed images that help in planning treatment or surgical interventions.

Indications

• Suspected congenital heart defects
• Aortic aneurysms or dissections
• Evaluation of aortic stenosis or other valve disorders
• Pre-surgical planning
• Follow-up assessments post-surgery or intervention

Preparation

• Fasting for 6-8 hours before the procedure
• Adjustments to medications as directed by the healthcare provider
• Pre-procedure blood tests and imaging assessments
• An IV line for administering medications and contrast dye

Procedure Description

1. Anesthesia: Local anesthesia to numb the insertion site; sedation if needed.
2. Catheter Insertion: A catheter is inserted through an artery, usually in the groin or wrist, and guided to the heart.
3. Injection of Dye: Contrast dye is injected into the supravalvular area of the aorta.
4. Imaging: Real-time X-ray images (fluoroscopy) are taken to visualize the blood flow and structural details.
5. Monitoring: The procedure is supervised with continuous monitoring of heart function.
6. Interpretation and Reporting: The images are analyzed and a detailed report is prepared by the cardiologist.

Duration

The procedure typically takes 1-2 hours, including preparation and recovery time.

Setting

Performed in a specialized catheterization lab within a hospital.

Personnel

• Interventional cardiologist
• Cardiology nurses
• Radiology technicians
• Anesthesiologist (if sedation is used)

Risks and Complications

• Allergic reaction to the contrast dye
• Bleeding or infection at the catheter insertion site
• Arrhythmias (irregular heartbeats)
• Damage to blood vessels
• Kidney damage due to the contrast dye (especially in patients with pre-existing kidney issues)
• Rare risks include stroke or heart attack

Benefits

• Accurate diagnosis of aortic and heart conditions
• Detailed images to guide treatment decisions
• Minimal recovery time compared to more invasive procedures
• Can prevent complications by enabling timely intervention

Recovery

• Rest for a few hours post-procedure
• Monitoring at the hospital to ensure no immediate complications
• Instructions on care of the insertion site
• Resume normal activities within a day or two unless otherwise advised
• Follow-up appointment for results discussion and further management

Alternatives

• Non-invasive imaging tests (e.g., MRI, CT angiography)
  • Pros: No catheter insertion, lower risk of complications.
  • Cons: May not provide as detailed images, not suitable for all patients.
• Traditional angiography
  • Pros: Excellent imaging detail.
  • Cons: More invasive, similar risk profile.

Patient Experience

Patients may feel slight pressure or discomfort at the insertion site. The contrast dye may cause a warm or flushed feeling. Post-procedure soreness and bruising at the catheter site are common but manageable. Pain management and comfort measures, including medications, are typically provided.