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Deployment of septal occluder right pulmonary artery/pulmonary vein fistula

Date: Apr 16, 2012

Question:

Deployment of septal occluder for right pulmonary artery/pulmonary vein fistula. This was performed by IR radiologist and cardiologist. I am not sure about catheter selections and what imaging studies I can charge for the IR lab. I am going to condense the actual report below. Lt. common fem venous access obtained, Grollman cath and wire utilized to gain access to rt. superior pulmonary vein cath removed for exchange length wire that was left in place. Rt. common fem venous access obtained, Grollman cath utilized to gain access to rt. pulmonary artery. Cath exchanged by sheath and the sheath positioned in rt. main pulmonary artery with AP and lat PA-grams performed. Additional angiography of rt. lower lobe pulmonary artery performed. Could not identify definitively the fistula and used wire and catheter to negotiate the fistula tract and gain access to left atrium. Lt. atrial angiography confirmed access in the lt. atrium. At this point the cardiologist entered the procedure and you have already answered my coworkers question regarding the occluder. I was thinking of using 75741, 36015, 36015, and 75774? Thank you for your help on this unusual case!
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