KPanzer
New
- Messages
- 3
- Location
- Valencia, PA
If an Impella device was inserted via an axillary conduit creation (coded as X2HL0F9); would the insertion of the Impella device be considered a percutaneous (02HA3RZ) or open approach (02HA0RZ)?
"A right infraclavicular incision was made. Muscle was divided until the right axillary artery was identified. Clamps were placed on the artery proximally and distally. An arteriotomy was created. A 10mm gelweave graft was brought to the field, was beveled and trimmed, and anastomosed to the artery using a 5-0 prolene. After completion, the clamps were removed, hemostasis was obtained, and the graft was tunneled through the subcutaneous tissues and brought out through a counter incision inferior to the primary incision. A sheath was placed. A pigtail catheter was passed with a wire through the sheath, through the graft, through the artery, and ultimately across the aortic valve. The wire was exchanged for an impella wire. The pigtail was removed and the Impella device was inserted over the wire and across the valve. The wire was removed and Impella flow was initiated."
"A right infraclavicular incision was made. Muscle was divided until the right axillary artery was identified. Clamps were placed on the artery proximally and distally. An arteriotomy was created. A 10mm gelweave graft was brought to the field, was beveled and trimmed, and anastomosed to the artery using a 5-0 prolene. After completion, the clamps were removed, hemostasis was obtained, and the graft was tunneled through the subcutaneous tissues and brought out through a counter incision inferior to the primary incision. A sheath was placed. A pigtail catheter was passed with a wire through the sheath, through the graft, through the artery, and ultimately across the aortic valve. The wire was exchanged for an impella wire. The pigtail was removed and the Impella device was inserted over the wire and across the valve. The wire was removed and Impella flow was initiated."