Hello: I am hoping someone can assist me with this!
Procedure performed: 1. Interposition 8-mm gore-tex graft from Common Fem to SFA including Profunda. 2. Sartorius muscle flap for coverage of gore-tex graft.
Old incision was excised and extended a subcutaneousl flap laterally, being careful not to compromise the blood supply to the muscle. (15738). We then turned our attention to the vessel. Dissected out the SFA, Profunda artery and an additional posterior branch. Inspected the artery, appeard infected anterior & left laterally, so rather than patch this, we elected to remove that segment of the artery. A fishmouth anastomisis was then performed proximally, with a the 8-mm graft distally. The graft had a tapering tonge, posteriorly attaching to the rim of the profunda and anteriorly onto the SFA. Anastomoses were made witha 5-0 gort-tex suture. The areas around this had been debrided and we then detached the sartorius at the tendinous insertion and rolled that from lateral to medial thus covering the graft entirely.
Two days prior to this pt had a blowout of the Left common femoral Artery with significant bleed this was controlled emergently and cultures came back as having staph aureus, so plans were made to resect this region.....
Pt had A SFA embolectomy done 2 month ago. He has no bypass grafts.
For the muscle flap I am using the 15738. Not sure on the gortex graft.
Was looking at repair code 35286.
Any suggestions would be appreciated!!!
Thank you
Procedure performed: 1. Interposition 8-mm gore-tex graft from Common Fem to SFA including Profunda. 2. Sartorius muscle flap for coverage of gore-tex graft.
Old incision was excised and extended a subcutaneousl flap laterally, being careful not to compromise the blood supply to the muscle. (15738). We then turned our attention to the vessel. Dissected out the SFA, Profunda artery and an additional posterior branch. Inspected the artery, appeard infected anterior & left laterally, so rather than patch this, we elected to remove that segment of the artery. A fishmouth anastomisis was then performed proximally, with a the 8-mm graft distally. The graft had a tapering tonge, posteriorly attaching to the rim of the profunda and anteriorly onto the SFA. Anastomoses were made witha 5-0 gort-tex suture. The areas around this had been debrided and we then detached the sartorius at the tendinous insertion and rolled that from lateral to medial thus covering the graft entirely.
Two days prior to this pt had a blowout of the Left common femoral Artery with significant bleed this was controlled emergently and cultures came back as having staph aureus, so plans were made to resect this region.....
Pt had A SFA embolectomy done 2 month ago. He has no bypass grafts.
For the muscle flap I am using the 15738. Not sure on the gortex graft.
Was looking at repair code 35286.
Any suggestions would be appreciated!!!
Thank you