davidskm
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CAN YOU HELP ME FIGURE OUT HOW TO CODE THIS PROCEDURE(#2)
NAME OF PROCEDURES:
1. Aortic valve replacement with an Edwards Lifesciences bovine pericardial Magna Ease 23 mm valve, model #3300TF6, serial #3024439.
2. Autologous aortic patch repair of the left ventricular outflow tract underneath the commissure between the non and the left coronary.3. Replacement of the ascending aorta from the sinotubular junction up to the innominate artery level with a Hemashield 28 mm graft under deep hypothermic circulatory arrest.
4. Double coronary artery bypass with sequential saphenous vein bypass to a 1.4 mm diagonal and then to a 1.6 mm left anterior descending.
{1.33405, 2.HELP CODE, 3.33860, 4. 33511, +33508}
heres the description of the op note:
Our attention was then directed back to the aortic root. Inspection of the aortic root revealed that there was only mild dilatation, but the root was not thickened. There was a bicuspid aortic valve with fusion of the left and the right cusp. There was a larger broad-based reddish color vegetation found on both leaflets of the aortic valve. Both leaflets of the aortic valve were excised. There was some inflammation found in the left ventricular outflow tract just underneath the commissure between the left and the non area extending into the anterior leaflet of the mitral valve. This area was sharply debrided with a scalpel until we reached clean muscular tissue. A triangular piece of the native aorta which was resected was used to patch up this area between the annulus and the anterior leaflet of the mitral valve with running stitch of 5-0 Prolene sutures. Thirteen 2-0 Ethibond sutures with small pledget were placed in an everting technique around the aortic valve annulus, some of the suture over the commissure between the left and the non where the patch was placed. The pledget was placed in a through and through manner with the pledget lying outside the ascending aorta. Then, a 23 mm bovine pericardial Magna Ease valve was rinsed with the last rinse done with ceftriaxone antibiotic. The suture was then passed through the sewing skirt of the valve. The valve was lowered into position. The sutures were tied and cut with satisfactory sitting of the valve. The sinotubular junction of the patient's native aorta was anastomosed onto the proximal end of the Hemashield graft with running stitch of 4-0 Prolene sutures.
NAME OF PROCEDURES:
1. Aortic valve replacement with an Edwards Lifesciences bovine pericardial Magna Ease 23 mm valve, model #3300TF6, serial #3024439.
2. Autologous aortic patch repair of the left ventricular outflow tract underneath the commissure between the non and the left coronary.3. Replacement of the ascending aorta from the sinotubular junction up to the innominate artery level with a Hemashield 28 mm graft under deep hypothermic circulatory arrest.
4. Double coronary artery bypass with sequential saphenous vein bypass to a 1.4 mm diagonal and then to a 1.6 mm left anterior descending.
{1.33405, 2.HELP CODE, 3.33860, 4. 33511, +33508}
heres the description of the op note:
Our attention was then directed back to the aortic root. Inspection of the aortic root revealed that there was only mild dilatation, but the root was not thickened. There was a bicuspid aortic valve with fusion of the left and the right cusp. There was a larger broad-based reddish color vegetation found on both leaflets of the aortic valve. Both leaflets of the aortic valve were excised. There was some inflammation found in the left ventricular outflow tract just underneath the commissure between the left and the non area extending into the anterior leaflet of the mitral valve. This area was sharply debrided with a scalpel until we reached clean muscular tissue. A triangular piece of the native aorta which was resected was used to patch up this area between the annulus and the anterior leaflet of the mitral valve with running stitch of 5-0 Prolene sutures. Thirteen 2-0 Ethibond sutures with small pledget were placed in an everting technique around the aortic valve annulus, some of the suture over the commissure between the left and the non where the patch was placed. The pledget was placed in a through and through manner with the pledget lying outside the ascending aorta. Then, a 23 mm bovine pericardial Magna Ease valve was rinsed with the last rinse done with ceftriaxone antibiotic. The suture was then passed through the sewing skirt of the valve. The valve was lowered into position. The sutures were tied and cut with satisfactory sitting of the valve. The sinotubular junction of the patient's native aorta was anastomosed onto the proximal end of the Hemashield graft with running stitch of 4-0 Prolene sutures.