CPT® Code 33822

1. Indications

The procedure coded as CPT® 33822 is indicated for the surgical repair of a patent ductus arteriosus (PDA) in patients who are younger than 18 years. The primary indications for this procedure include:

• Patent Ductus Arteriosus (PDA) - A condition where the ductus arteriosus fails to close after birth, leading to abnormal blood flow between the aorta and pulmonary artery.
• Heart Failure Symptoms - Patients may exhibit signs of heart failure due to the increased workload on the heart caused by the persistent ductus.
• Respiratory Distress - Infants and children may experience difficulty breathing or other respiratory issues as a result of the altered blood flow.
• Failure to Thrive - Children may not gain weight or grow as expected due to the effects of PDA on their overall health.

2. Procedure

The surgical procedure for repairing a patent ductus arteriosus (PDA) as described by CPT® Code 33822 involves several critical steps:

• Step 1: Anesthesia Administration - The patient is placed under general anesthesia to ensure they are completely unconscious and pain-free during the procedure.
• Step 2: Posterolateral Thoracotomy - A surgical incision is made in the chest, specifically in the posterolateral area, to provide access to the heart and the ductus arteriosus.
• Step 3: Exposure of the Ductus Arteriosus - The surgeon carefully dissects the surrounding tissues to expose the patent ductus arteriosus, ensuring that the area is clear for the repair.
• Step 4: Ligation of the Ductus - The ductus arteriosus is first suture ligated, which involves tying it off to prevent blood flow through the vessel.
• Step 5: Division of the Ductus - Following ligation, the ductus arteriosus is then divided (cut) to completely separate it from the aorta and pulmonary artery, effectively repairing the PDA.
• Step 6: Closure of the Thoracotomy - After the ductus has been repaired, the surgeon closes the thoracotomy incision in layers, ensuring proper healing and minimizing complications.

3. Post-Procedure

Post-procedure care following the repair of a patent ductus arteriosus includes monitoring the patient in a recovery area for any immediate complications. Patients are typically observed for signs of respiratory distress, bleeding, or infection. Pain management is provided as needed, and the patient may require supplemental oxygen initially. Follow-up appointments are essential to assess the surgical site and ensure proper healing. Long-term follow-up may also be necessary to monitor heart function and overall health, as well as to address any potential complications that may arise from the procedure.