Percutaneous fetal balloon valvuloplasty for pulmonary atresia with intact ventricular septum

NICE interventional procedures guidance [IPG176] Published date:

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The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on percutaneous fetal balloon valvuloplasty for pulmonary atresia with intact ventricular septum.

In accordance with the Interventional Procedures Programme process guide, guidance on procedures with special arrangements are reviewed 3 years after publication and the procedure is reassessed if important new evidence is available.

The guidance was considered for reassessment in January 2013 and it was concluded that NICE will not be updating this guidance at this stage. However, if you believe there is new evidence which should warrant a review of our guidance, please contact us via the email address below.

  • Description

    Congenital heart defects are the most common type of birth defect and include critical pulmonary stenosis and pulmonary atresia with intact ventricular septum (PAIVS).

    Pulmonary stenosis in utero is usually mild and typically does not adversely affect the pregnancy. However the more severe lesion of pumonary atresia with intact ventricular septum has a high rate of postnatal morbidity and mortality.

    Percutaneous fetal balloon valvuloplasty is performed at 21-32 weeks' gestation under maternal local anaesthesia and sedation using ultrasound guidance.

  • OPCS4.6 Code(s)

    R04.8 Other specified therapeutic percutaneous operations on fetus

    Y40.3 Balloon dilation of organ NOC

    A code from category Y95.- Gestational age must be assigned in a subsidiary position where this information is available.

    Y53.2 Approach to organ under ultrasonic control

    Z32.4 Pulmonary valve

    The NHS Classifications Service of NHS Connecting for Health is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS.   The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided.

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