Wiki Minimally invasive exploration of aortic valve

sandy06

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Minimally invasive exploration of aortic valve.

We then instituted full
cardiopulmonary bypass. Further dissection of the pericardium off the
ascending aorta was performed allowing placement of pericardial stay
sutures. The aorta was circumferentially dissected as well as the
right atrium. A left ventricular vent was inserted through the right
superior pulmonary vein. The aorta was then cross clamped. One dose of
antegrade cardioplegia was given. Thereafter, a transverse aortotomy
was performed over the previous suture line. The aortic valve was
inspected it was noted to be approximate 21 mm valve probably causing
mild patient prosthetic mismatch, but there was no evidence of any
perivalvular separation of the valve causing perivalvular leak. In
addition the mechanical valve opened and closed properly. There was no
evidence of pannus formation. There was no evidence of the septal
hypertrophy, which will require removal of the valve. Of note, the
valve was well-seated it was then endothelialized over the sewing
cuff, as well as the previously placed sutures. A decision was made at
this point not to proceed further and accept the valve as is and the
aortotomy was closed with a 4-0 Prolene suture in a continuous over-
and-over fashion utilizing a two-layer closure.

Can someone please help with this Opt Note, I'm so Confused as to which cpt code(s) 33315 and 33496. I'll appreciate any insight that you can give.
thanks,
 
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