TN 19 (12-18)

DI 23022.540 Aortic Atresia

    

COMPASSIONATE ALLOWANCE INFORMATION

AORTIC ATRESIA

ALTERNATE NAMES

Aortic Valve Atresia; Aortic Valve Stenosis

DESCRIPTION

Aortic Atresia is a rare congenital heart defect in which there is no opening from the left ventricle of the heart into the aorta. This type of obstruction interrupts blood flow from the left ventricle of the heart to the body. Because of this blockage, the only other way for blood to flow to the rest of the body is through another structure in the heart called the ductus ateriosus. Aortic atresia usually occurs in combination with other heart defects, such as hypoplastic left heart syndrome. This combination is the most frequent cause of congestive heart failure and death in the neonatal period (the first 28 days of life).

Infants with aortic valve atresia surviving into adulthood may develop problems with their heart functioning later in life due to worsening of the condition. Over time, the surgical treatments that were used at infancy to repair the aortic heart valve may leave scar tissue behind, increasing the chances of abnormal heart rhythm (arrhythmia) and an area for infection called SBE (subacute bacterial endocarditis).

DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND ICD-9-CM CODING

Diagnostic testing:

  • Chest x-ray;

  • Electrocardiogram;

  • Echocardiogram;

  • Cardiac catheterization; and

  • Cardiac magnetic resonance imaging (MRI).

Physical findings: The physical findings associated with aortic atresia include:  

  • Cyanosis (blue-tinged skin);

  • Dyspnea (shortness of breath);

  • Rapidly progressive heart failure with hepatomegaly (enlarged liver); and

  • A gallop rhythm.

ICD-9: 747.22

TREATMENT

The treatment of aortic atresia is based on the severity of the condition. Infants are usually treated with medications to keep the ductus arteriosis open, and staged surgical intervention. Adults should be monitored by a cardiologist to assess the need for medication, surgery, and for heart infections (endocarditis) throughout their lifetime.

PROGRESSION

A diagnosis of aortic atresia is usually made shortly after birth. Disease progression is variable based on the severity of the congenital heart defects and the response to medication and surgical interventions.

SUGGESTED PROGRAMMATIC ASSESSMENT*
Suggested MER for Evaluation:
  • Clinical history and examination that describes the diagnostic features of the impairment;

  • Cardiology consultation reports;

  • Imaging studies of the heart; and

  • Blood laboratory testing including hematocrit, arterial blood gases, or arterial O2 saturation.

Suggested Listings for Evaluation:
DETERMINATION

LISTING

REMARKS
Meets 4.06

104.06 A, B, C, or D

Equals
* Adjudicators may, at their discretion, use the Medical Evidence of Record or the listings suggested to evaluate the claim. However, the decision to allow or deny the claim rests with the adjudicator.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0423022540
DI 23022.540 - Aortic Atresia - 12/03/2018
Batch run: 12/03/2018
Rev:12/03/2018