bhargavi
Guru
INDICATIONS FOR THE PROCEDURE Acute anterior ST-segment elevation myocardial
infarction. The patient was brought into the catheter lab emergently. Upon
arrival to the cardiac catheter lab he had a ventricular fibrillation cardiac
arrest. Defibrillation was performed successfully. He reverted back into
severe sinus bradycardia with a long period of unresponsiveness however
responded after. Groins were prepped and draped in an aseptic technique and
6-French sheath was inserted in the right femoral artery. Diagnostic
left-to-right coronary arteries were performed showing the following
1. The angiographically normal.
2. Left anterior descending is a large vessel. Proximally it is fifty percent
occluded before take off a large diagonal branch. The diagonal has an area of
80% stenosis. The remainder of the left anterior descending has nonobstructive
disease.
3. The left circumflex artery is anatomically nondominant with mild
nonobstructive disease. It supplies only one obtuse marginal branch. The
right coronary artery is 100% occluded proximally.
Using a JR-4 guiding catheter an ATW marker wire was able to cross the
occlusion of the right coronary artery. It was predilated to 2.5 x 15 mm
balloon followed by the insertion of the insertion of 3.5 x 23 mm Xience Alpine
drug eluting stent and post dilated with 3.5 x 15 mm noncompliant balloon with
excellent result and no residual stenosis. Left heart catheterization with
left ventricular angiogram actually showed no wall motion abnormality with
preserved ejection fraction of 15%. Impression
1. Cardiac arrest in the setting of inferior ST elevation myocardial
infarction. This patient was resuscitated with cardioversion.
2. 100 percent occlusion of the right coronary artery treated successfully
with insertion of 3.5 at 23 mm Xience Alpine drug eluting stent.
3. Preserved left ventricular function.
4. Fifty percent left anterior descending and 80% diagonal disease.
my question is should i bill cpr with 93458/c9606 ?
thanks in advance
infarction. The patient was brought into the catheter lab emergently. Upon
arrival to the cardiac catheter lab he had a ventricular fibrillation cardiac
arrest. Defibrillation was performed successfully. He reverted back into
severe sinus bradycardia with a long period of unresponsiveness however
responded after. Groins were prepped and draped in an aseptic technique and
6-French sheath was inserted in the right femoral artery. Diagnostic
left-to-right coronary arteries were performed showing the following
1. The angiographically normal.
2. Left anterior descending is a large vessel. Proximally it is fifty percent
occluded before take off a large diagonal branch. The diagonal has an area of
80% stenosis. The remainder of the left anterior descending has nonobstructive
disease.
3. The left circumflex artery is anatomically nondominant with mild
nonobstructive disease. It supplies only one obtuse marginal branch. The
right coronary artery is 100% occluded proximally.
Using a JR-4 guiding catheter an ATW marker wire was able to cross the
occlusion of the right coronary artery. It was predilated to 2.5 x 15 mm
balloon followed by the insertion of the insertion of 3.5 x 23 mm Xience Alpine
drug eluting stent and post dilated with 3.5 x 15 mm noncompliant balloon with
excellent result and no residual stenosis. Left heart catheterization with
left ventricular angiogram actually showed no wall motion abnormality with
preserved ejection fraction of 15%. Impression
1. Cardiac arrest in the setting of inferior ST elevation myocardial
infarction. This patient was resuscitated with cardioversion.
2. 100 percent occlusion of the right coronary artery treated successfully
with insertion of 3.5 at 23 mm Xience Alpine drug eluting stent.
3. Preserved left ventricular function.
4. Fifty percent left anterior descending and 80% diagonal disease.
my question is should i bill cpr with 93458/c9606 ?
thanks in advance