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Bypass graft; autogenous composite, 2 segments of veins from 2 locations (List separately in addition to code for primary procedure)
CPT4 code
Name of the Procedure:
Bypass Graft; Autogenous Composite, 2 Segments of Veins from 2 Locations
Summary
This procedure involves using segments of the patient’s own veins taken from two different locations to create a bypass graft. It is typically performed in conjunction with another primary surgical procedure.
Purpose
Medical Condition
The bypass graft procedure is intended to restore blood flow around a blocked or narrowed artery.
Goals
- Improve blood circulation.
- Alleviate symptoms such as pain or swelling caused by poor blood flow.
- Prevent tissue damage due to inadequate blood supply.
Indications
Symptoms
- Severe pain due to artery blockage.
- Ulcers or non-healing wounds.
- Gangrene or tissue necrosis. ##### Patient Criteria
- Patients with significant artery blockages not suitable for less invasive procedures.
- Individuals with healthy veins suitable for grafting.
Preparation
- Fasting for at least 8 hours before the procedure.
- Discontinuation of certain medications (e.g., blood thinners) as instructed by the doctor.
- Preoperative assessments, including blood tests, ECG, and imaging studies.
Procedure Description
- Anesthesia is administered, typically general anesthesia.
- Veins are harvested from two different locations on the patient’s body.
- Incisions are made at the blockage site and along the path of the intended bypass.
- The harvested vein segments are surgically connected to create a new pathway around the blocked artery.
- The graft is checked for proper blood flow.
- Incisions are closed and bandaged.
Tools and Equipment
- Scalpel and surgical instruments.
- Clamps to control blood flow.
- Suture materials for joining vein segments.
Anesthesia
General anesthesia is commonly used, ensuring the patient is asleep and pain-free.
Duration
The procedure typically takes about 3 to 6 hours, depending on complexity and patient condition.
Setting
The procedure is performed in a hospital's operating room.
Personnel
- Surgeon specialized in vascular surgery.
- Surgical nurses.
- Anesthesiologist.
- Surgical assistants.
Risks and Complications
Common Risks
- Infection at incision sites.
- Bleeding or bruising. ##### Rare Risks
- Blood clots.
- Graft failure or blockage.
- Adverse reactions to anesthesia. ##### Management Management includes post-operative monitoring, antibiotics for infections, and medications to prevent blood clots.
Benefits
- Improved blood flow.
- Relief from pain and other symptoms.
- Prevention of tissue damage.
- Benefits are typically realized within a few weeks post-operation.
Recovery
- Hospital stay for a few days post-surgery.
- Wound care instructions and medication regimen to prevent infections.
- Gradual return to normal activities over 4 to 6 weeks.
- Follow-up appointments to monitor graft function and overall recovery.
Alternatives
Treatment Options
- Angioplasty with stenting.
- Medications to manage symptoms.
- Lifestyle changes. ##### Pros and Cons
- Less invasive options may be suitable for less severe blockages but might not provide the same long-term results as a bypass graft.
Patient Experience
During Procedure
- The patient will be under general anesthesia and won’t feel any pain. ##### After Procedure
- Post-operative pain managed with medications.
- Some discomfort and tightness in the chest and incision sites.
- Instructions on activity restrictions and wound care to promote healing and comfort.