CPT® Code 93530

Deleted

1. Indications

The right heart catheterization procedure is indicated for patients presenting with congenital cardiac anomalies. These anomalies may include a variety of structural heart defects that affect the normal flow of blood through the heart and lungs. The procedure is performed to evaluate the severity of these conditions, assess the function of the right heart chambers, and determine the appropriate course of treatment.

• Congenital Cardiac Anomalies Evaluation of structural defects in the heart that are present from birth, which may impact hemodynamics and overall cardiac function.

2. Procedure

The right heart catheterization procedure involves several critical steps to ensure accurate assessment and diagnosis of congenital cardiac anomalies.

• Step 1: Preparation The procedure begins with the patient being positioned comfortably, and the skin over the catheter access site, typically the right femoral vein, is thoroughly cleansed to minimize the risk of infection. A local anesthetic is then injected to numb the area, ensuring the patient experiences minimal discomfort during the procedure.
• Step 2: Accessing the Vein Following the administration of local anesthesia, a small stab incision is made in the skin over the access site. A needle is carefully inserted into the blood vessel, allowing for the introduction of a sheath that will facilitate the passage of the catheter.
• Step 3: Inserting the Guidewire A guidewire is threaded through the femoral vein, advancing through the external iliac vein and into the inferior vena cava. This guidewire serves as a pathway for the catheter to follow into the heart.
• Step 4: Catheter Insertion Once the guidewire is in place, a catheter is inserted over the guidewire and advanced into the inferior vena cava. The catheter is then maneuvered into the right atrium, followed by the right ventricle, and finally into the pulmonary arteries.
• Step 5: Evaluation As the catheter traverses the right side of the heart and enters the pulmonary arteries, the right heart chambers are inspected for any congenital anomalies. Blood pressure measurements are taken in the right atrium and ventricle, and oxygen levels are assessed to evaluate cardiac function. The tricuspid and pulmonary valves are also examined for any abnormalities.
• Step 6: Angiogram (if applicable) If necessary, a separately reportable angiogram of the right heart and/or pulmonary arteries may be performed to obtain detailed imaging of the vascular structures, aiding in the diagnosis and treatment planning.
• Step 7: Completion Upon completion of the procedure, the catheter is carefully withdrawn from the body. Compression is applied to the venous access site to prevent bleeding, and a dressing is placed to protect the area and promote healing.

3. Post-Procedure

After the right heart catheterization, patients are typically monitored for any complications, such as bleeding or infection at the access site. The recovery process may vary depending on the individual patient and the complexity of the procedure performed. Patients are advised to rest and avoid strenuous activities for a specified period. Follow-up appointments may be scheduled to discuss the findings of the procedure and to determine the next steps in management based on the evaluation of the congenital cardiac anomalies.