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Closure of semilunar valve (aortic or pulmonary) by suture or patch

CPT4 code

Name of the Procedure:

Closure of Semilunar Valve (Aortic or Pulmonary) by Suture or Patch

Summary

This surgical procedure involves repairing a defective aortic or pulmonary valve by sewing it closed with sutures or using a patch. This is done to ensure the valve functions correctly, allowing proper blood flow through the heart.

Purpose

The procedure aims to address conditions like valve insufficiency or leakage where the semilunar valves (aortic or pulmonary) do not close properly. The goal is to restore normal valve function, improve blood circulation, and alleviate symptoms like shortness of breath and fatigue.

Indications

  • Symptoms of valve insufficiency, such as shortness of breath, chest pain, or dizziness.
  • Diagnosis of aortic or pulmonary valve regurgitation via echocardiogram or other imaging techniques.
  • Presence of congenital valve defects or damage due to infections or diseases like endocarditis.

Preparation

  • Fasting for at least 8 hours before the procedure.
  • Adjustment or cessation of certain medications as advised by the healthcare provider.
  • Preliminary diagnostic tests, including blood tests, echocardiogram, ECG, and possibly a cardiac catheterization.

Procedure Description

  1. The patient is administered general anesthesia.
  2. The surgeon makes an incision in the chest to access the heart.
  3. The heart is temporarily stopped, and a heart-lung machine takes over blood circulation.
  4. The defective semilunar valve (aortic or pulmonary) is exposed.
  5. The surgeon repairs the valve: either suturing any tears or placing a patch over the damaged area.
  6. The heart is restarted, and normal blood flow is restored.
  7. The chest incision is closed with sutures or staples.

Duration

The procedure typically takes around 2 to 4 hours, depending on the complexity of the repair.

Setting

This surgery is performed in a hospital's operating room, equipped with advanced cardiac surgery facilities.

Personnel

  • Cardiothoracic surgeon
  • Anesthesiologist
  • Surgical nurses
  • Perfusionist
  • Cardiologist (optional for intraoperative guidance)

Risks and Complications

  • Infection
  • Bleeding
  • Blood clots leading to stroke or heart attack
  • Heart rhythm problems
  • Valve dysfunction recurrence
  • Adverse reactions to anesthesia

Benefits

  • Improved valve function and blood circulation.
  • Relief from symptoms such as shortness of breath and fatigue.
  • Potentially enhanced quality of life and physical capacity.

Recovery

  • Hospital stay of about 5 to 7 days, including time in the intensive care unit.
  • Gradual resumption of normal activities over several weeks.
  • Post-operative medications to manage pain and prevent blood clots or infection.
  • Follow-up appointments for monitoring heart function.

Alternatives

  • Medication management to control symptoms (less effective for severe valve issues).
  • Valve replacement surgery, which involves replacing the faulty valve with a mechanical or biological valve.
  • Balloon valvuloplasty (less invasive but typically for less severe cases).

Patient Experience

During the procedure, patients are under general anesthesia and will not feel any discomfort. Postoperatively, patients may experience pain at the incision site, managed with pain medication. Full recovery can take several weeks, and patients should follow a heart-healthy lifestyle and attend regular follow-up appointments to ensure optimal recovery and valve function.

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