Reimplantation, visceral artery to infrarenal aortic prosthesis, each artery (List separately in addition to code for primary procedure)
CPT4 code
Name of the Procedure:
Reimplantation, Visceral Artery to Infrarenal Aortic Prosthesis (Each Artery)
Summary
This procedure involves surgically attaching a visceral artery (e.g., one supplying the liver or intestines) to an artificial section of the aorta located below the kidneys. This helps restore blood flow when the natural artery-to-aorta connection is damaged or obstructed.
Purpose
The procedure addresses conditions like aneurysms, significant blockages, or traumatic injuries of the aorta and its branching visceral arteries. The goal is to restore proper blood circulation, prevent potential organ damage, and improve overall cardiovascular function.
Indications
- Abdominal aortic aneurysms affecting visceral arteries
- Severe atherosclerosis causing blockages
- Traumatic injury to the aorta or visceral arteries
- Medical conditions requiring aortic bypass for improved blood flow
Patients suitable for this procedure typically have significant arterial disease, atherosclerosis, or traumatic injury that compromises blood circulation to essential organs.
Preparation
- Fasting for at least 8 hours before the procedure
- Temporary discontinuation of certain medications (e.g., blood thinners)
- Pre-operative imaging studies like CT scans or MRIs to map the affected areas
- General health assessments, including blood tests and cardiovascular evaluations
Procedure Description
- Anesthesia: General anesthesia is administered to ensure the patient is asleep and pain-free.
- Incision: A surgical incision is made in the abdomen to access the aorta and the affected visceral artery.
- Dissection: The surgeon carefully dissects and prepares the visceral artery and the aortic section for reimplantation.
- Prosthesis Placement: An artificial aortic graft (prosthesis) is placed in the infrarenal section of the aorta.
- Reimplantation: The visceral artery is meticulously attached to the prosthetic graft ensuring a secure and functional connection.
- Closure: The surgical site is closed with sutures or surgical staples.
Duration
Approximately 4 to 6 hours, depending on the complexity and number of arteries involved.
Setting
Typically performed in a hospital setting within a specialized operating room equipped for vascular surgery.
Personnel
- Vascular surgeon
- Surgical assistants
- Anesthesiologist
- Operating room nurses
- Post-operative care team
Risks and Complications
- Infection at the surgical site
- Bleeding or blood clots
- Graft failure or leakage
- Injury to surrounding tissues or organs
- Adverse reactions to anesthesia
- Renal complications
Benefits
- Restoration of normal blood flow to vital organs
- Reduction of symptoms related to ischemia (lack of blood supply)
- Prevention of further arterial damage or rupture
- Improved overall organ function and patient quality of life
Recovery
- Hospital stay of 5 to 7 days post-operation
- Pain management with prescribed medications
- Restricted activities, including lifting and strenuous exercise, for several weeks
- Follow-up appointments for monitoring graft function and healing
- Gradual return to normal activities as advised by the healthcare team
Alternatives
- Endovascular aneurysm repair (EVAR)
- Medication management for atherosclerosis
- Lifestyle changes (diet, exercise)
- Watchful waiting for less severe cases
Each alternative has its own benefits and risks, with surgical options providing more definitive solutions for severe cases, while non-surgical options may be appropriate for less critical conditions.
Patient Experience
During the procedure, the patient will be under general anesthesia, ensuring they feel no pain. Post-operatively, patients might experience discomfort, controlled with medication. Gradual improvement in symptoms related to impaired blood flow can be expected. Full recovery may take several weeks, with careful monitoring and follow-up care to ensure optimal outcomes.