here's one idea...
33822/33824]: The physician gains access to the mediastinum through an incision through the posterolateral left chest wall (posterolateral thoracotomy). The physician dissects through the posterior chest wall musculature to expose the superior mediastinum. The physician dissects away the tissues surrounding the ductus and passes several heavy ligatures around the ductus and ties it off (ligation) at each end. The physician occludes the ductus with vascular clamps and divides the ductus with scissors. The physician closes the aortic end with suture, then closes the pulmonary stump. The physician removes the vascular clamps, sutures the pleura closed, closes the remaining surgical incisions and dresses the chest wall wound. The physician may leave chest tubes and/or a mediastinal drainage tube in place following the procedure. Report 33824 if the patient is 18 years and older.
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