Axillary TAVI
Access
7F Pinnacle - Right IJ
7F Slender - Right Radial
7F Slender - Left Radial
8F Arrow - L Axillary
Equipment
- Micropuncture
- 7F Pinnacle
- (2) 7F Slenders
- 8F Arrow
- 12F Dilator
- (2) Perclose
- 5F Angled Pigtail
- 4F Straight Pigtail (on order, will need to use 5F in the meantime)
- 5F AL1
- Runthrough wire
- 0.35 x 260 J Wire
- Safari
- Mustang Balloon of Physicians preference (Most likely an 8)
- Indeflator for mustang
Procedural Steps
If anesthesia needs an A-line for induction we will upsize for procedure (they will have access to contralateral radial artery) Obtain all access points as listed above, most likely starting with the IJ.
5F Pigtail advanced from the left radial, subclavian angiography performed. Micropuncture with ultrasound, fluoro and pigtail guidance.
Pre-close x 2. 8F arrow sheath advanced.
4F pigtail advanced from R Radial, root shot performed
AL1 advanced from the L Radial for valve crossing in standard fashion.
Pigtail to LV, exchanged for Safari.
12F dilator in and out, E Sheath advanced.
Valve advanced and deployed.
Delivery removed and runthrough and mustang advanced to the sublcavian for tamponade during access closure.
DSA.
TR bands and go home.
