The National Institute for Health and Care Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Sutureless Aortic Valve Replacement for aortic stenosis.
Aortic stenosis occurs when the aortic valve, which separates the main pumping chamber of the heart from the blood circulation system of the body, becomes narrowed. This reduces the flow of blood out of the heart. During sutureless aortic valve replacement surgery, a cut is made in the chest to get to the heart. A heart–lung bypass machine takes over blood circulation during the operation and the heart is then stopped. The aortic valve is removed and replaced with an artificial valve (prosthesis) that is secured into place using no or minimal guiding sutures (stitches). The heart is then restarted and the cut in the chest is closed. Because the procedure can be done more quickly than traditional aortic valve surgery, less time is spent on the heart–lung bypass machine and side effects from the operation may be reduced.
One of the following OPCS-4 codes would be assigned:
K26.1 Allograft replacement of aortic valve
K26.2 Xenograft replacement of aortic valve
K26.3 Prosthetic replacement of aortic valve
K26.4 Replacement of aortic valve NEC
Y73.1 Cardiopulmonary bypass
If concurrent annuloplasty of aortic valve is also performed code this in addition using the following code:
K34.3 Annuloplasty of valve of heart NEC