02TH0ZZ
Resection Pulmonary Valve to No Qualifier with No Device, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | 2 Heart and Great Vessels |
| Operation | T Resection |
| Body Part | H Pulmonary Valve |
| Approach | 0 Open |
| Device | Z No Device |
| Qualifier | Z No Qualifier |
Operation Definition
Cutting out or off, without replacement, all of a body part
Procedure Overview
Resection in the heart and great vessels describes cutting out an entire body part with nothing put in its place. In this body system that most often means removing a defined anatomic segment, such as an atrial appendage, or excising an entire structure that has become diseased or is no longer needed.
This differs from trimming away a portion of tissue; Resection applies to a complete structure being taken out, not a partial removal. Reasons for performing it range from eliminating a source of dangerous blood clots, as with an atrial appendage tied to stroke risk in atrial fibrillation, to removing a segment that is obstructing normal circulation or that was created for an earlier stage of treatment and is no longer required.
Because the heart and great vessels have a limited number of discrete, whole body parts recognized in this classification, true Resection procedures here are less common than in other body systems where whole organs are removed.
Anatomy & Axis Detail
Pulmonary Valve
The pulmonary valve is the semilunar valve situated between the right ventricular outflow tract and the pulmonary artery, regulating forward flow of deoxygenated blood to the lungs while preventing regurgitation. Resection of the pulmonary valve is performed when the leaflets are severely stenotic, dysplastic, or destroyed by endocarditis to the point that repair is not feasible, commonly as a step preceding valve replacement or as part of the Ross procedure where the valve is harvested for use as an autograft in the aortic position. Its relatively thin-walled, low-pressure location compared to the left heart valves means the surrounding right ventricular outflow tract anatomy, including the infundibulum, must be assessed for associated obstruction or dilation. Documentation should reflect whether the resected valve is discarded or repurposed as an autograft, since the latter defines the distinct Ross technique.
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.
Coding & Documentation
Coders should assign Resection here only when the documentation confirms an entire body part, as defined in the body part table, was removed and nothing was left in that location. If any portion of the structure remains, the correct root operation is usually Excision instead, so the note needs to be explicit about complete removal.
A frequent error is defaulting to Resection whenever a heart structure is cut out, without checking whether the body part is defined as a discrete whole entity in this body system. Left atrial appendage occlusion or excision procedures are a common source of this confusion, since some techniques resect the appendage while others merely close it off, which is a different root operation entirely.