Radiofrequency valvotomy for pulmonary atresia

NICE interventional procedures guidance [IPG95] 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 radiofrequency valvotomy for pulmonary atresia.

  • Description

    Radiofrequency valvotomy is used to treat pulmonary atresia, a congenital malformation of the pulmonary valve in which the valve orifice fails to develop. The valve is completely closed thereby obstructing the outflow of blood from the heart to the lungs. Babies with this type of cyanotic congenital heart disease survive only for the first few days of life while the normal fetal shunts between left and right circulations remain patent. Without an operation in that period to open the pulmonary valve or to make a shunt between the aorta and the pulmonary arteries, the condition is fatal.

    The standard treatment for pulmonary atresia is open heart surgery which includes the Fontan procedure (the surgical creation of a right ventricular bypass by directly connecting either the right atrium or the superior or inferior vena cava and the pulmonary artery) and the Blalock-Taussig shunt (a palliative procedure where a shunt is created to allow blood to pass from the aorta to the pulmonary artery by dividing the left subclavian artery and connecting it to the left pulmonary artery). Further open heart surgery may include open surgical valvotomy.

    Radiofrequency valvotomy is a minimally invasive cardiac catheterisation procedure which involves creating an opening in the blocked pulmonary valve followed by dilation using balloon angioplasty. It avoids open surgery but some children will later need a permanent shunt procedure.

  • OPCS4.6 Code(s)

    K35.4 Percutaneous transluminal pulmonary valvotomy

    Includes: Percutaneous transluminal balloon valvotomy of pulmonary valve

    Y11.4 Radiofrequency controlled thermal destruction of organ NOC

    Y53.- Approach to organ under image control

    Note: Codes within category Y53.- are used as secondary codes to classify interventions that are percutaneous and require some form of image control: if the method of image control is unspecified, Y53.9 Unspecified approach to organ under image control is assigned.

    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.  www.connectingforhealth.co.uk/clinicalcoding

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