Suture repair of aorta or great vessels; with cardiopulmonary bypass
CPT4 code
Name of the Procedure:
Suture Repair of Aorta or Great Vessels with Cardiopulmonary Bypass (CPB)
Summary
This surgical procedure involves repairing the aorta or other major blood vessels using sutures while the patient's heart and lungs are temporarily supported by a cardiopulmonary bypass machine. This machine takes over the function of the heart and lungs during the procedure to ensure blood circulation and oxygenation.
Purpose
The procedure addresses conditions such as aortic aneurysms, aortic dissections, or traumatic injuries to the great vessels. The goal is to repair damage and restore normal blood flow, preventing potentially life-threatening complications like rupture or severe bleeding.
Indications
- Presence of an aortic aneurysm or dissection
- Traumatic injury to the aorta or major blood vessels
- Severe stenosis or blockage of the aorta or great vessels
- Conditions where non-surgical treatments are ineffective or unsuitable
Preparation
- Patients may need to fast (no food or drink) for 8-12 hours before the procedure.
- Medications may be adjusted or temporarily discontinued as directed by the healthcare provider.
- Preoperative assessments including blood tests, ECG, chest X-ray, and imaging studies such as CT or MRI scans of the aorta.
Procedure Description
- The patient is placed under general anesthesia.
- An incision is made in the chest to access the aorta or great vessels.
- The patient is connected to the cardiopulmonary bypass machine, which takes over the function of the heart and lungs.
- The surgeon uses sutures to repair the damaged area of the aorta or great vessels.
- Once the repair is complete, the heart and lungs are gradually taken off bypass support.
- The incision is closed using sutures or staples.
Duration
The procedure typically takes 3 to 6 hours, depending on the complexity of the repair.
Setting
The procedure is performed in a hospital operating room, often in a specialized cardiovascular or thoracic surgery department.
Personnel
- Cardiothoracic surgeon
- Surgical assistants
- Perfusionist (operates the cardiopulmonary bypass machine)
- Anesthesiologist
- Circulating nurses and scrub nurses
Risks and Complications
- Infection
- Bleeding
- Blood clots
- Stroke
- Organ dysfunction (e.g., kidney failure)
- Reactions to anesthesia
- Prolonged recovery or complications related to the cardiopulmonary bypass
Benefits
- Repairing the damaged vessel prevents life-threatening complications such as rupture or severe bleeding.
- Improved blood flow and reduced symptoms associated with the condition.
- Long-term survival and quality of life improvements.
Recovery
- Patients are typically monitored in the ICU immediately following the procedure.
- Pain management includes medications to control discomfort.
- Gradual resumption of normal activities over several weeks.
- Follow-up appointments for wound care and monitoring of recovery.
- Restrictions may include avoiding heavy lifting and strenuous activities for a specified period.
Alternatives
- Endovascular repair (less invasive but may not be suitable for all cases)
- Medication management for less severe conditions
- Watchful waiting in select cases where immediate surgery is not necessary
Patient Experience
- Patients will be under general anesthesia and will not feel pain during the procedure.
- Postoperative pain and discomfort are managed with medications.
- Emotional support and reassurance are provided to address any anxiety or concerns about the surgery and recovery process.