Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator with hypothermic circulatory arrest
CPT4 code
Name of the Procedure:
Anesthesia for Procedures on Heart, Pericardial Sac, and Great Vessels of Chest; with Pump Oxygenator and Hypothermic Circulatory Arrest
Summary
This procedure involves administering anesthesia for surgeries on the heart, the pericardial sac, and the major blood vessels in the chest. It uses a pump oxygenator with hypothermic circulatory arrest, a technique that cools the body to protect the brain and organs while stopping blood circulation during complex heart surgeries.
Purpose
The procedure is used to manage anesthesia during intricate heart surgeries that require stopping the blood circulation. The goals are to provide a safe and pain-free experience for the patient while ensuring vital organs are protected from damage through hypothermia.
Indications
- Severe heart conditions that require surgery, such as aneurysms or congenital heart defects.
- Need for surgical interventions on the pericardial sac or great vessels.
- Situations where stopping blood flow is necessary to perform the surgery safely.
Preparation
- Patients may need to fast for several hours before surgery.
- Medication adjustments might be required based on individual health conditions.
- Pre-surgical diagnostic tests include blood work, imaging studies, and possibly a cardiac catheterization.
Procedure Description
- Preparation: Patient is prepped and brought to the operating room (OR).
- Anesthesia: General anesthesia is administered to ensure the patient is unconscious and pain-free.
- Cooling: The body is cooled to induce hypothermia.
- Circulatory Arrest: Blood circulation is stopped using a heart-lung machine.
- Surgery: Surgeons perform the required operation on the heart, pericardial sac, or great vessels.
- Rewarming: The body is gradually warmed back to normal temperature.
- Weaning Off Pump: The patient’s heart takes over circulation from the heart-lung machine.
- Waking Up: Anesthesia is reversed, and the patient regains consciousness.
Duration
The entire process can take several hours, varying based on the complexity of the surgery.
Setting
This procedure is performed in a specialized operating room within a hospital.
Personnel
- Cardiothoracic surgeon
- Anesthesiologist
- Surgical nurses
- Perfusionist (operates the heart-lung machine)
- Surgical technologists
Risks and Complications
- Common Risks: Bleeding, infections, reactions to anesthesia.
- Rare Risks: Stroke, organ injury, failure to restore normal circulation, complications from hypothermia. Management includes close monitoring and immediate medical interventions.
Benefits
- Corrects severe heart and vessel conditions.
- Improves overall heart function and patient survival rates.
- Benefits may be realized immediately post-surgery or over time as recovery progresses.
Recovery
- Post-surgery, patients are closely monitored in the ICU.
- Recovery may include pain management, physical therapy, and gradual return to normal activities.
- Follow-up appointments are necessary to ensure proper healing.
- Recovery time varies, often ranging from weeks to months.
Alternatives
- Less invasive procedures or medications might be options for some patients.
- Risks and benefits of alternatives differ and should be discussed with a healthcare provider.
Patient Experience
- During the procedure, the patient is under general anesthesia and unconscious.
- Post-surgery, the patient may experience discomfort and require pain relief.
- Emotional and physical support, including rehabilitation, may be necessary during recovery.