024J082
Creation Tricuspid Valve to Common Atrioventricular Valve with Zooplastic Tissue, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | 2 Heart and Great Vessels |
| Operation | 4 Creation |
| Body Part | J Tricuspid Valve |
| Approach | 0 Open |
| Device | 8 Zooplastic Tissue |
| Qualifier | 2 Common Atrioventricular Valve |
Operation Definition
Putting in or on biological or synthetic material to form a new body part that to the extent possible replicates the anatomic structure or function of an absent body part
Procedure Overview
Creation procedures in the heart and great vessels involve building a new anatomic structure using biological tissue or synthetic material when a structure is absent or cannot be repaired by other means. Rather than repairing or replacing an existing part, the surgeon fashions a substitute intended to approximate the shape and function of what would normally be there. In cardiac surgery this typically comes up in complex congenital reconstructions, where a chamber, valve, or vascular connection never developed properly and must be constructed essentially from scratch using patch material, conduit, or grafted tissue.
Patients and families encounter this concept most often in the context of staged single-ventricle repairs or other rare structural anomalies, where surgeons build a functional pathway that nature did not provide. The goal is to restore circulation as close to normal physiology as achievable, understanding that a created structure is an approximation rather than a true native part.
Anatomy & Axis Detail
Tricuspid Valve
Creation of a tricuspid valve is performed in rare circumstances where the valve between the right atrium and right ventricle is congenitally absent or so severely dysplastic that no functional leaflet tissue remains to repair, most often encountered in complex forms of tricuspid atresia or unbalanced atrioventricular canal defects where a new valve mechanism must be fashioned using autologous pericardium, nonautologous tissue, or a prosthetic substitute. Because the tricuspid valve operates under lower right-sided pressures than the left-sided valves, the constructed valve must still reliably prevent regurgitation into the right atrium while accommodating the anatomic variability typical of the congenital defects that necessitate this approach. This procedure is coded separately from tricuspid valve replacement since no native valve is being substituted, and documentation should identify the specific material used to build the new valve, as this determines the applicable device value.
Approach: Open
Open approach means the surgeon cuts through skin, mucous membrane, or other tissue layers to physically expose the target site to view before performing the procedure. It gives direct visualization and hands-on access, distinguishing it from Percutaneous approaches where instruments pass through a small puncture without exposing the site. Open is typical for procedures needing wide access, such as most laparotomies.
Device: Zooplastic Tissue
Zooplastic Tissue designates material of animal origin, most often bovine or porcine, used to replace or reinforce human anatomic structures such as heart valves or grafts. It is procured from a non-human source and processed for implantation, setting it apart from autologous tissue taken from the patient's own body and from nonautologous tissue sourced from another human donor.
Qualifier: Common Atrioventricular Valve
This qualifier designates the common atrioventricular valve found in complete atrioventricular canal defect, where mitral and tricuspid tissue has not fully separated. It contrasts with the left and right atrioventricular valve qualifiers, which apply once the valve has been divided or in anatomy where two distinct AV valves already exist.
Coding & Documentation
This root operation is used sparingly in the heart and great vessels body system, and documentation must clearly describe that a new structure was fabricated rather than repaired, replaced, or bypassed - operative notes should specify the material used and confirm no native equivalent existed to work from. Coders should be alert to conflating Creation with Replacement, since both involve placing material into the body: Replacement swaps out an existing body part, while Creation applies only when the part being formed did not previously exist in that configuration. Because this operation is uncommon outside select congenital and reconstructive contexts, coders should verify against current facility coding guidance before assigning it and avoid defaulting to it whenever unfamiliar graft or patch material appears in the note.