Insertion of ventricular assist device, implantable intracorporeal, single ventricle
CPT4 code
Name of the Procedure:
Insertion of Ventricular Assist Device, Implantable Intracorporeal, Single Ventricle
Summary
This procedure involves surgically implanting a device to help a failing heart pump blood. The device supports a single ventricle of the heart and is placed entirely inside the body.
Purpose
The procedure addresses severe heart failure, where the heart is unable to pump blood effectively. The goal is to improve blood circulation, relieve symptoms of heart failure, and enhance the patient's quality of life.
Indications
- Advanced heart failure unresponsive to medication.
- Severe left or right ventricular dysfunction.
- Patients awaiting heart transplantation.
- Symptoms such as extreme fatigue, shortness of breath, and fluid retention.
Preparation
- Fasting for at least 8 hours before surgery.
- Discontinuing certain medications as instructed by the doctor.
- Undergoing diagnostic tests such as echocardiograms, blood tests, and possibly cardiac catheterization.
Procedure Description
- Administration of general anesthesia to ensure the patient is unconscious and pain-free.
- Making an incision in the chest to access the heart.
- Implanting the ventricular assist device (VAD) near the heart, with a pump connected to the ventricle needing support.
- Connecting the device to the main arteries to assist in blood circulation.
- Closing the chest incision and ensuring the device operates correctly.
Tools and equipment may include surgical scalpels, VAD components, heart-lung bypass machine, and advanced monitoring systems.
Duration
Typically, the procedure takes 4 to 6 hours.
Setting
The procedure is performed in a hospital operating room.
Personnel
- Cardiothoracic surgeon
- Surgical nurses
- Anesthesiologist
- Perfusionist
- Cardiology team support
Risks and Complications
- Infection at the incision site or device.
- Blood clots leading to stroke or other complications.
- Bleeding during or after surgery.
- Device malfunction or failure.
- Risks associated with general anesthesia.
Benefits
- Improved heart function and blood circulation.
- Reduced symptoms of heart failure.
- Enhanced quality of life and physical capabilities.
Recovery
- Initial recovery in the Intensive Care Unit (ICU) for close monitoring.
- Possible hospital stay of 2 to 4 weeks.
- Gradual increase in physical activity as guided by the healthcare team.
- Lifelong follow-up appointments to monitor device function and heart health.
- Possible dietary and medication adjustments.
Alternatives
- Medication therapy to manage heart failure symptoms.
- Heart transplantation for eligible candidates.
- Other mechanical circulatory support devices.
- Pros and cons vary, with medications potentially being less invasive but less effective in severe cases, while heart transplantation is a more definitive solution but comes with risks and the need for a donor heart.
Patient Experience
During the procedure, the patient will be under general anesthesia and will not feel pain. After the procedure, the patient may experience soreness and discomfort at the incision site, managed with pain medication. There will be a period of monitoring and support in the ICU, followed by gradual recovery and rehabilitation.