Transcatheter implantation of wireless pulmonary artery pressure sensor for long-term hemodynamic monitoring, including deployment and calibration of the sensor, right heart catheterization, selective pulmonary catheterization, radiological supervision an
CPT4 code
Name of the Procedure:
Transcatheter implantation of wireless pulmonary artery pressure sensor for long-term hemodynamic monitoring
Common names: Wireless pulmonary artery pressure sensor implantation, Hemodynamic monitoring sensor deployment
Summary
This minimally invasive procedure involves inserting a small, wireless sensor into the pulmonary artery via a catheter. The sensor continuously measures the pressure within the artery, providing valuable data for long-term monitoring of heart and lung function.
Purpose
The procedure aims to manage and monitor heart conditions such as heart failure by providing continuous, real-time data on pulmonary artery pressures. This data helps healthcare providers adjust treatments to better manage the patient's condition and potentially prevent hospitalizations.
Indications
- Chronic heart failure
- Pulmonary hypertension
- Patients with frequent hospitalizations due to exacerbation of heart failure
- Poorly controlled symptoms despite medical therapy
Preparation
- Fasting for at least 6-8 hours before the procedure
- Stopping certain medications as advised by the doctor
- Pre-procedural imaging studies, such as echocardiography or chest X-ray
- Blood tests to assess kidney function and coagulation status
Procedure Description
- The patient is given local anesthesia and mild sedation.
- Right heart catheterization is performed by inserting a catheter through a vein, usually in the groin or neck.
- The catheter is guided to the pulmonary artery with the aid of fluoroscopic (X-ray) imaging.
- Selective pulmonary catheterization is done to position the catheter in the precise location.
- The wireless sensor is deployed through the catheter into the pulmonary artery.
- Once in place, the sensor is activated and calibrated to ensure accurate pressure readings.
- The catheter is then carefully removed.
- Radiological supervision continues throughout the procedure to ensure proper placement and function of the sensor.
Duration
The entire procedure typically takes about 1 to 2 hours.
Setting
The procedure is usually performed in a hospital's cardiac catheterization lab or interventional radiology suite.
Personnel
- Interventional cardiologist or radiologist
- Cardiac nurse
- Cath lab technician
- Radiology technician
- Anesthesiologist or sedation nurse
Risks and Complications
- Infection at the catheter insertion site
- Bleeding or hematoma
- Blood vessel damage
- Sensor malfunction or dislodgment
- Allergic reactions to contrast dye or medications
- Rarely, arrhythmias or heart attack
Benefits
- Continuous, real-time monitoring of pulmonary artery pressure
- Improved management of heart failure symptoms
- Potential reduction in hospitalizations
- Tailored treatment adjustments based on precise data
Recovery
- Post-procedure monitoring in a recovery area for a few hours
- Instructions to keep the insertion site clean and dry
- Avoiding strenuous activities for a few days
- Follow-up appointments to assess the function of the sensor
- Patients may resume normal activities within a week, with specific instructions provided by the doctor
Alternatives
- Traditional right heart catheterization for periodic pressure measurements
- Non-invasive imaging techniques such as echocardiography
- Medical management with medication adjustments based on symptoms
Pros and cons of alternatives:
- Traditional catheterization provides accurate data but is invasive and requires repeated procedures.
- Non-invasive imaging is safer but less precise.
- Medication adjustments without precise data can be less effective in managing complex cases.
Patient Experience
Patients typically feel mild discomfort at the catheter insertion site and may experience some pressure during catheterization. Post-procedure, they might have some soreness or bruising, which can be managed with over-the-counter pain relievers. Most patients can return to their normal activities within a week.