Home » VA Primary Hyperaldosteronism (AVS + Adrenalectomy)

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Matthew A. Sparks, MD

Associate Director-
Harpreet Singh, MD

Associate Director-
Rasha Raslan, MD

Program Coordinator-
Ashley McPherson

Haskel Schiff Chief Fellow-
Samiddhi Weerasiri, MD

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VA Primary Hyperaldosteronism (AVS + Adrenalectomy)

To Refer  patient to Adrenal Vein Sampling in CPRS:

instructions

Patient counseling and documentation template by Kourany:

“We discussed the findings with the patient. We discussed possibility of referring the patient for adrenal vein sampling to assess if he has lateralization (may benefit from surgical adrenalectomy of the hypersecretory side) absence of that (in this case, the treatment would be medical). I described to patient how the procedure is done, possible risks, and possibleoutcomes (including possibility of uninterpretable results). I told patient that the adrenal vein sampling would be done only if patient would be willing to undergo surgery if patient is confirmed to have unilateral adrenal gland hypersecretion. Informed patient that in such circumstances, surgery would very likely lead to improvement in hypokalemia (and thus no or less need of K supplementation), likely lead to improved BP control with the need of fewer number of anti-HTN meds (though patient may still need some anti-HTN meds given the common occurrence of primary HTN), and a likely lower risk of cardiovascular and renal problems in the future. Patient voiced understanding and agreement of the above and elected to proceed with adrenal vein sampling (and subsequent surgery if found to be needed). Informed patient that that the adrenal vein sampling cannot be done at the VA and that patient would be sent to Duke under VA community office care. Patient agreed.  CITC consult was placed”.

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Place a CITC consult as follows:

  • Contact Dr. Paul Suhocki (suhocki@duke.edu) who usually does the procedure at Duke if questions
  • See screenshots below on how to order:

Add New Order, then “90 Consult/Procedure”,

then “16 Fee Basis/Community Care Consults”,

then “93 COMMUNITY CARE-IMAGING ANGIO/NEURO/INTERVENTIONAL-AUTO”

Type of Service: Evaluation and Recommendations

  • Chief Complaint: Patient with primary hyperaldosteronism; need adrenal vein sampling to rule out unilateral vs bilateral adrenal hyperplasia. Procedure cannot be done at the Durham VA. Please refer to Duke.
  • Patient History / Clinical Findings / Diagnosis (Co-Morbidities): Put some history here.
  • Provisional Diagnosis: Other Primary Hyperaldosteronism(ICD-10-CM E26.09)
  • You may TEAM message CITC office (e.g. Dr. Indira Velasquez) with questions.