Repair of cor triatriatum or supravalvular mitral ring by resection of left atrial membrane
CPT4 code
Name of the Procedure:
Repair of Cor Triatriatum or Supravalvular Mitral Ring by Resection of Left Atrial Membrane
Common name: Cor Triatriatum Repair
Summary:
This surgical procedure aims to correct a rare congenital heart defect known as cor triatriatum, where a fibromuscular membrane divides the left atrium into two chambers. The procedure involves resecting this membrane to restore normal blood flow within the heart.
Purpose:
Medical Condition: Cor triatriatum or supravalvular mitral ring
Goals: To remove the obstructive membrane from the left atrium, allowing for proper blood flow, improved heart function, and relief of symptoms.
Indications:
Symptoms/Conditions:
- Shortness of breath
- Fatigue
- Palpitations
- Pulmonary hypertension
Patient Criteria:
- Diagnosis confirmed via echocardiography or cardiac MRI
- Presence of significant symptoms interfering with daily activities
Preparation:
Pre-procedure Instructions:
- Fasting for at least 8 hours before surgery
- Medication adjustments as directed by the cardiologist
Diagnostic Tests:
- Echocardiogram
- MRI or CT scan of the heart
- Blood tests
Procedure Description:
- Anesthesia: General anesthesia is administered.
- Access: A median sternotomy or minimally invasive approach is made to access the heart.
- Cardiopulmonary Bypass: The patient is placed on a heart-lung machine.
- Exposure: The left atrium is carefully opened to expose the membrane.
- Resection: The abnormal membrane is precisely excised using surgical instruments.
- Closure: The heart and chest are closed, and the patient is gradually weaned off the heart-lung machine.
Tools and Equipment:
- Scalpel
- Surgical scissors
- Cardiopulmonary bypass machine
Duration:
The procedure typically takes about 3-4 hours, including preparation and recovery time.
Setting:
Performed in a hospital operating room equipped for cardiac surgery.
Personnel:
- Cardiothoracic surgeon
- Anesthesiologist
- Surgical nurses
- Perfusionist (operates heart-lung machine)
- Scrub techs
Risks and Complications:
Common Risks:
- Bleeding
- Infection
- Arrhythmias
Rare Complications:
- Stroke
- Heart failure
- Need for reoperation
Management: Close post-operative monitoring and appropriate medical interventions.
Benefits:
Expected Benefits:
- Relief of symptoms
- Improved heart function
- Enhanced quality of life
Timeline for Benefits: Within weeks to months post-surgery.
Recovery:
Post-procedure Care:
- ICU stay for monitoring
- Gradual increase in physical activity
Expected Recovery Time:
- 4-6 weeks for complete recovery
- Restrictions: Avoid heavy lifting, strenuous exercise
Follow-up: Regular cardiac check-ups and imaging to monitor heart function.
Alternatives:
Other Options:
- Medical management (less effective for severe cases)
- Catheter-based interventions (limited applicability)
Pros and Cons:
- Surgery offers more definitive correction but comes with higher risks.
- Medical management is less invasive but might not fully alleviate symptoms.
Patient Experience:
During Procedure:
- Patient is under general anesthesia and will not feel pain.
After Procedure:
- Initial discomfort and pain managed with medications
- Likely ICU stay for close monitoring
- Gradual improvement in symptoms and physical condition