Close left atrial appendage
Is there a code for capturing closure of a left atrial appendage using a 'clip' device?
I was hoping he did a limited MAZE however that is not the case or am I missing something. Please see below:
The patient was brought to the operating room and in the supine position, she
was placed under satisfactory double-lumen endotracheal anesthesia.
Prophylactic systemic antibiotics were administered and she was prepped and
draped in a sterile fashion. Now, in the left third intercostal space, at the
mid axillary line, a 5 millimeter port was placed and CO2 was insufflated.
Another 5 millimeter port was placed in the mid clavicular line, in about the
second intercostal space, and a larger port was placed down in the mid
axillary line at about the fifth intercostal space. This was enlarged so that
it would allow the clip to be introduced into the chest.
Now, with great care to preserve the integrity of the phrenic nerve and the
recurrent laryngeal nerve, I opened the pericardium posterior to the phrenic
nerve. A pericardial stay suture was placed in the anterior leaflet of the
pericardium, just posterior to the phrenic nerve, and this was lifted up and
brought out through the anterior chest wall to help protect the phrenic nerve
and to expose the left atrial appendage. Now, the clip was introduced through
the most caudad port site and it was manipulated around the atrial appendage
and down to the very base, where it was closed. There was good closure and
total occlusion of the atrial appendage.
Julie Graham, BA, CPC, CCC