Sesame

Sesame Procedure 8/14/25

Dr.Daniels/Dr.Spies

Watch outs!!

• Pericardiocentesis

• ECMO - Perfusion on Standby

• Valve implantation - Edwards Rep on standby

TEE for procedure, Biplane used for procedure, patient arms over head

Access:

• Left femoral artery 8Fr

• right femoral arteryt 8fr

• right femoral vein 8fr

Rough idea of procedure steps:

6fr angled pigtail advanced left femoral artery access.

20 for 20 acist aortic root angiogram

20 for 20 acist LV gram

black marker to draw on screen

big pedal needed for flouro

Agilis and 6F HSI inserted across aortic valve

Astato 40 and corsair inserted through HSI

wire across septum

7Fr JR guide advanced to LV

Tulip snare inserted via JR4 guide

wire snared

corsair removed

piggyback and navicross inserted

snared removed

---Ready for laceration--(ready for emergency watchout)

Septum laceration

procedure complete