aprilnc
New
I would appreciate any help that anyone can give me! I do not have a lot of experince with vascular coding and this procedure was quite involved and I would like help with possible CPT codes. Thanks.
OP-NOTE
Pre Op Dx: GSW to ABD
Post op dx: GSW to inferior vena cava (left side/ anatomic variant) with 50% denuding of the posterolateral inferior vena cava wall.
The vascular injury was noted. Then after tracking it to cephalad, it was felt to be left-sided inferior vena cava. The entire aorta and Inferior vena cava were then exposed with vascular control. The left gonadal vein was ligated to give more exposure, and divided and ligated proximalla dn distally with Vicryl.
The injury was essentially just above the vena cava-common iliac vein junction. The aorta was dissected free in its abdominal portion and bilateral iliac ateries were also identified with no evidence of aortic injury. With the inital repair, there was significan compromise, probably nearly 90% stricture of the vena cava, and at this point in time, it was felt that a patch repair would be best suited. The proximal vena cava was controlled with a stainsky clamp. The distal vena cava at the vena cava-iliac junction was controlled with a straight Satinsky clamp, The previous suture was removed and the vena cava was debrided. It appeared to be that at least 50% of the vena cava wall had been injured. This was debrided and a Gore-Tex patch was placed over this and sewn in place with a running 5-0 Prolene circumferentially.
OP-NOTE
Pre Op Dx: GSW to ABD
Post op dx: GSW to inferior vena cava (left side/ anatomic variant) with 50% denuding of the posterolateral inferior vena cava wall.
The vascular injury was noted. Then after tracking it to cephalad, it was felt to be left-sided inferior vena cava. The entire aorta and Inferior vena cava were then exposed with vascular control. The left gonadal vein was ligated to give more exposure, and divided and ligated proximalla dn distally with Vicryl.
The injury was essentially just above the vena cava-common iliac vein junction. The aorta was dissected free in its abdominal portion and bilateral iliac ateries were also identified with no evidence of aortic injury. With the inital repair, there was significan compromise, probably nearly 90% stricture of the vena cava, and at this point in time, it was felt that a patch repair would be best suited. The proximal vena cava was controlled with a stainsky clamp. The distal vena cava at the vena cava-iliac junction was controlled with a straight Satinsky clamp, The previous suture was removed and the vena cava was debrided. It appeared to be that at least 50% of the vena cava wall had been injured. This was debrided and a Gore-Tex patch was placed over this and sewn in place with a running 5-0 Prolene circumferentially.