View source for Micra post TAVI

In the course of a TAVI, it is sometimes necessary to implant a leadless pacemaker. This facility uses the Micra device. This page will guide you on this procedure in the post-TAVI setting.

== MORE INFO LOCATED ON MICRA-ROMICK PAGE ==

===Already on the table:===
*Micropuncture set
*150 J-wire
*2x 20cc syringes
*1-2x 60cc syringes

===Open:===
*12/18/24 dilators
*0 PDS 
*180 Amplatz Super Stiff, 7cm tip
*Micra sheath from behind EP

If pt. is dependent on TPM and it is in the RFV, assume you will be switching the TPM to the LFV and open:
*New ultrasound probe cover
*8.5 x 35 Brite-tip sheath
*5fr. Ballon tip TPM catheter

===Prep:===
*Set ACIST at 5ml/sec, 20ml total (to fill syringes).
*20 and 60cc syringes filled with Hep Saline
*Flush and assemble Micra Sheath
*RN preps hep saline on IV pump @ 125ml/hr 

===Procedure:===
====If on TPM====
#Access LFV and insert 8.5 Brite Tip
#Insert balloon-tip TPM and establish capture
#Wire RFV with Amplatz SS
#Dilate and place Micra sheath
#Attach Hep Saline drip
#Micra delivery system is flushed gently with 60cc syringe and inserted
#Fill delivery system with contrast
#Before deployment, do LAO with contrast
#Do RAO with saline flush (clears delivery system)
#Deploy Micra
#Tug test under 30 fps. cine
#Flush delivery system with full 60 cc syringe
#Pull suture
#Remove delivery system
#Place purse-string and woggle
#Remove sheath

[[Category:Procedures]]