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Can we bill for the reimplantation of both the renal artery and IMA? 

Date: Mar 13, 2023


Incision in midline sternum-pubis we dissected the infrarenal aorta. Blunt dissection at infrarenal aorta completely freed of the surrounding tissue.  Please note that inferior mesenteric vein was ligated during the process. Retroperitoneum opened. Iliac arteries and aorta was clamped. Aorta was opened in the middle. Identified 3 lumbar arteries which were controlled with the help of 2-0 silk ties. Our cryo artery was brought into the field, soaked graft with rifampin.  The side branches were tested on the back field and all but 1 was tied off. The proximal aorta was cut in a beveled fashion. Graft was cut to the length we need. Brought to RT retroperitoneum where we had exposed the RT EIA the hypogastric artery anastomosis was made again in an end-to-end fashion.LT side anastomosis was made at the level of the iliac bifurcation. Next the IMA was dissected further and in the it was anastomosed to the main graft with the reimplantation of the renal arteries. Tongue of omentum created & brought to the wall of the retroperitoneum. 35638, 35697 x’s 2 & 49905?

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