Wiki Attempted Left Atrial Appendage Occlusion

Robbin109

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I have an attempted LAAO but MD was unable to access the right femoral vein.

Report:

"#6-French venous sheath and arterial sheath were placed on the left femoral vein and artery. After completing the placement, a right femoral vein was attempted, but unfortunately due to anatomy, we were unable to obtain access. but instead cannulated the artery a second time, requiring a second #6 French sheath.

In order to localized the right femoral vein in a better fashion, a crossover from the left of the right iliac venous system was performed and a glidewire was placed crossing the femoral head for landmark. Under fluoroscopic control, reattempt at accessing the femoral vein was done with both distended Seldinger needle as well as a micropuncture. Despite multiple attempts, we were unable to cannulate the right femoral vein and the procedure was aborted."

What can I code in this situation?

Thanks!!!
 
Cannulation of the right femoral artery; 36140, possibly? From what I read it seems like he had two sheaths and was able to get it only in the femoral artery. Initially, I thought you might be able to get 36247 for the right iliac but it was not a selective placement.

HTH
 
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