Repair of cardiac wound; without bypass
CPT4 code
Name of the Procedure:
Repair of Cardiac Wound; without Bypass
Common name: Heart Wound Repair
Technical term: Non-Bypass Cardiac Wound Repair
Summary
Heart wound repair without bypass is a surgical procedure to fix punctures, tears, or other injuries to the heart tissue without using a heart-lung machine to divert blood flow.
Purpose
This procedure addresses traumatic injuries to the heart. The goal is to stop bleeding, repair damaged tissue, and restore normal heart function. Successful repair is vital to prevent severe complications, such as cardiac tamponade or heart failure.
Indications
- Open or penetrating chest trauma
- Cardiac tamponade resulting from a wound
- Visible trauma to the heart tissue
- Hemodynamic instability due to cardiac injury
Preparation
- Patients must fast for 8-12 hours before the procedure.
- Regular medications may need to be adjusted or paused.
- Pre-operative imaging (e.g., echocardiogram, CT scan) to assess the extent of injury.
- Blood tests to evaluate the patient’s overall health.
Procedure Description
- Anesthesia: General anesthesia is administered to ensure the patient remains unconscious and pain-free.
- Incision: A thoracic incision is made to access the chest cavity.
- Assessment: The surgeon inspects the heart to locate and evaluate the wound.
- Repair: Using surgical sutures or patches, the surgeon repairs the heart tissue. Special tools like needles, surgical thread, and sometimes synthetic materials may be used.
- Hemostasis: Ensuring all bleeding is controlled.
- Closure: The chest cavity is closed, and a chest tube may be placed to drain fluids.
Duration
The procedure typically lasts 2-4 hours, depending on the extent of the injury.
Setting
Performed in a hospital's operating room.
Personnel
- Cardiothoracic surgeon
- Surgical nurses
- Anesthesiologist
- Operating room technician
Risks and Complications
- Infection
- Bleeding
- Damage to nearby structures (e.g., lungs, major blood vessels)
- Anesthesia-related complications
- Postoperative arrhythmias
- Pericardial effusion
Benefits
- Stops active bleeding
- Repairs heart tissue and restores function
- Prevents life-threatening complications Patients may notice improvements immediately, but full recovery can take weeks.
Recovery
- Hospitalization for monitoring (typically 7-10 days).
- Pain management with medications.
- Gradual return to normal activities over several weeks.
- Follow-up appointments to monitor heart function and wound healing.
Alternatives
- Non-surgical management: In cases where surgery is too risky, conservative management with medications and close monitoring may be considered, but this is generally less effective.
- Cardiopulmonary bypass repair: Used in more complex cases where bypass is deemed necessary.
Patient Experience
During the procedure, the patient will be under general anesthesia and unconscious. Post-surgery, there may be pain or discomfort managed with medications. The patient may have limitations on physical activity during recovery and should follow specific instructions to avoid complications. Comfort measures include adequate pain relief and support during recovery.