Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, age 1 year or older, for all noncoronary bypass procedures (eg, valve procedures) or for re-operation for coronary bypass more than 1 month after origin
CPT4 code
Name of the Procedure:
Anesthesia for procedures on the heart, pericardial sac, and great vessels of the chest with pump oxygenator, for patients age 1 year or older, for all non-coronary bypass procedures (e.g., valve procedures) or for re-operation for coronary bypass more than 1 month after the original surgery.
Summary
This procedure involves the administration of anesthesia to patients undergoing heart surgeries that are not related to coronary bypasses or are re-operations for bypasses conducted more than a month prior. It includes the use of a pump oxygenator, which temporarily takes over the function of the heart and lungs during surgery.
Purpose
The primary aim is to safely manage pain and consciousness during heart surgeries that involve complex operations on the heart, pericardium, or great vessels. This allows surgeons to perform intricate procedures without patient discomfort and with reduced surgical risk.
Indications
- Heart valve repair or replacement
- Surgery on the great vessels of the chest, such as the aorta
- Re-operative coronary artery bypass grafting (CABG) more than a month after the initial surgery
- Other non-coronary cardiac procedures requiring extensive surgical intervention
Preparation
- Patients may need to fast for several hours before the procedure.
- Medication adjustments may be required; specific instructions will be provided by the healthcare team.
- Pre-operative assessments, including blood tests, imaging studies, and an evaluation of the patient’s medical history, will be conducted.
Procedure Description
- The patient is brought to the operating room and placed on the operating table.
- Intravenous (IV) lines and monitoring equipment are set up.
- Anesthesia is administered to induce and maintain unconsciousness and pain control.
- A pump oxygenator, also known as a heart-lung machine, is connected to take over the functions of the heart and lungs during surgery.
- The surgical team performs the necessary heart procedure (e.g., valve repair/replacement).
- Once the surgery is completed, the heart-lung machine is gradually weaned off, and normal heart function is restored.
- The patient is monitored in a recovery unit until stable.
Duration
The entire procedure, including the surgery, typically ranges from 3 to 6 hours, depending on the complexity of the surgery.
Setting
This procedure is performed in a hospital operating room equipped with specialized cardiac surgery facilities.
Personnel
- Cardiac surgeons
- Anesthesiologists
- Perfusionists (specialists in operating the heart-lung machine)
- Surgical nurses and technicians
Risks and Complications
- Common risks: bleeding, infection, adverse reactions to anesthesia
- Rare risks: stroke, heart attack, organ dysfunction, complications from the heart-lung machine
- Management: Risks are minimized through careful monitoring and immediate intervention if complications arise.
Benefits
- Relief from cardiac symptoms such as chest pain, breathlessness, or valve dysfunction
- Improved heart function and overall health
- Enhanced quality of life post-recovery
Recovery
- Immediate post-procedure care involves close monitoring in an intensive care unit (ICU).
- Pain management, IV fluids, and medications will be provided.
- Expected recovery time varies but typically spans several weeks.
- Follow-up appointments are crucial for monitoring recovery and managing any long-term care needs.
Alternatives
- Medication management for mild cases
- Less invasive procedures such as catheter-based interventions
- Pros and cons: Alternatives may be less risky but might not offer the same efficacy for severe conditions needing surgical intervention.
Patient Experience
- During the procedure: The patient will be unconscious and pain-free due to anesthesia.
- After the procedure: There may be initial discomfort, managed through pain relief medications. Patients can expect a hospital stay of several days, with gradual improvement in strength and mobility during recovery.
Pain management and comfort measures are prioritized to ensure a smooth recovery process, with support from the healthcare team at every stage.