Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (eg, maze procedure), with cardiopulmonary bypass (List separately in addition to code for primary procedure)
CPT4 code
Name of the Procedure:
Operative Tissue Ablation and Reconstruction of Atria (Maze Procedure with Cardiopulmonary Bypass)
Summary
This medical procedure involves using specialized techniques to ablate, or destroy, abnormal tissue in the atria of the heart and reconstruct the atrial structure. It is often done in conjunction with other heart surgeries and involves a heart-lung machine (cardiopulmonary bypass) to maintain blood circulation and oxygenation during the procedure.
Purpose
The procedure is primarily used to treat atrial fibrillation (AF), a common type of irregular heartbeat. The goals are to restore normal heart rhythm, improve heart function, and decrease the risk of stroke associated with AF.
Indications
- Persistent or long-standing atrial fibrillation not responsive to medication or other treatments.
- Severe symptoms related to AF, such as fatigue, shortness of breath, or palpitations.
- Patients undergoing other cardiac surgeries who also have AF.
Preparation
- Fasting for at least 8 hours before the procedure.
- Discontinuation or adjustment of certain medications as advised by the doctor.
- Preoperative tests, including blood work, electrocardiogram (ECG), echocardiogram, and possibly a chest X-ray or CT scan.
Procedure Description
- Anesthesia is administered to put the patient to sleep.
- An incision is made in the chest to access the heart.
- The heart-lung machine is connected to take over the function of the heart and lungs.
- Specialized instruments create precise scars in the atria to disrupt the faulty electrical signals causing AF.
- The atrial tissues are then reconstructed to ensure proper blood flow and function.
- Once the ablation and reconstruction are completed, the heart-lung machine is disconnected, and the incision is closed.
Duration
The procedure typically takes 3 to 5 hours, depending on the complexity and additional surgeries being performed.
Setting
The procedure is performed in a hospital's cardiac surgery operating room.
Personnel
- Cardiothoracic surgeon
- Anesthesiologist
- Surgical nurses
- Perfusionist (operates the heart-lung machine)
Risks and Complications
- Bleeding and infection at the surgical site
- Blood clots leading to stroke or other complications
- Arrhythmias or irregular heartbeats
- Damage to nearby organs or tissues
- Adverse reactions to anesthesia
- Prolonged recovery time
Benefits
- Restoration of normal sinus rhythm
- Reduction in AF-related symptoms
- Lower risk of stroke and other AF-related complications
- Improved quality of life
Recovery
- Hospital stay of 5 to 7 days post-procedure.
- Monitoring of heart rhythm and function.
- Pain management with medications.
- Avoiding strenuous activities for several weeks.
- Follow-up appointments with the cardiologist.
Alternatives
- Medication management for atrial fibrillation.
- Catheter ablation (minimally invasive procedure).
- Lifestyle changes and monitoring.
- Pros and cons: Medications might not be effective for all patients, and catheter ablation is less invasive but sometimes less effective for severe cases.
Patient Experience
- General anesthesia means the patient will not be awake or feel pain during the procedure.
- Post-surgery, the patient may experience discomfort around the incision site, fatigue, and temporary changes in heart rhythm.
- Pain is managed with medications, and patients are gradually helped back to normal activity levels.