TAVI - CoreValve (Medtronic)

Transcatheter Aortic Valve Repair (Wikipedia) procedures utilize a femoral approach to deliver a stent-based aortic valve to the patients heart. There are two valve types available:

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Loading Instructions

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• CoreValve by Medtronic - This page
• Sapien 3 Ultra by Edwards - Sapien 3 procedure page

This procedure is usually done in Room 1, and requires a 5 person team: Front table scrub, Back table scrub (device prep), Circulator, Pacer/Circulator, and Recorder. The rep for the respective company will be present to assist with device prep except in the case of an emergency valve placement.

In rare cases, the BASILICA procedure will be necessary to split the existing valve leaflets to prevent blockage of the coronary arteries. In that situation, the equipment on the BASILICA page will be needed in addition to the equipment listed below.

Per Rosalie:

TAVR/TMVI

1. Edwards Sapien 3 Ultra (20, 23 & 26mm) and Sapien 3 (29mm) – scan the valve barcode (box) in McKesson for documentation and charges.  Bundle includes valve, delivery system, crimper, e sheath intro set, balloon cath & locking syringe.  With the new inventory system (POU) space is limited in entering item full description.   If pre dilatation Edwards balloon is necessary free text the balloon used in procedure notes (McKesson).
2. Medtronic Core Valve – all items are charge separately.  Scan all barcodes (delivery system, loading system and valve).

MITRAL CLIP (Mitral/Tricuspid):

1. Use the barcode on Mckesson screen in Lab 1 – Mitraclip (Abbott) bundle consists of (1) Steerable Guide Catheter, (2) NTR Clip Delivery System & (1) XTR Clip Delivery System.

Daniels/Spies - Draft

ACIST A1000V SYRINGE USED WITH 50/50 CONTRAST MIX

Sheaths:

• 5Fr Micropunture Kit
• 6Fr x 10cm sheath
• 8Fr x 10 cm sheath (Dilator used only)
• 8Fr x 35 cm Brite Tip Sheath
• 9Fr x 10cm sheath
• 33cm Cook sheath. Size dependent upon plan. Ask MD prior to opening. (14F, 16F, or 18F)
  • IF SHEATHLESS DELIVERY: 18F coons dilator and 14F Cook sheath post
  • IF Sheath with PRO system: 18F
  • IF Sheath with old system: 16F

Wires

• (2) Cordis 150J
• Cordis 260J
• Safari 2
• Terumo Stiff Straight Glidewire 0.035 x 150 cm

Catheters:

• 5Fr AL1 diagnostic
• 5Fr Ang Pigtail
• 5Fr Str Pigtail
• 5Fr JL4/JR4 (when doing coronary angiography)

Medications on table:

• Lido/Bupivicaine 50/50

• Epinephrine 10mcg/ml in red medallion syringe (From anesthesia)

Miscellaneous Supplies

• 3-port manifold kit
• Acist hand control
• 2L cold saline
• stopcock
• back table cover
• 20 ml syringe
• (3) Perclose

Transvenous pacemaker supplies

• 5Fr Josephson Pacing catheter
• Dual Red/Black Pacing Remington cables
• EP Quad Cable

PROCEDURAL INFO:

If a sheath is inserted prior to delivery system an 18F will be used.

If delivery system is inserted sheathless, a 14F cook sheath will be inserted after removal of the delivery system.

Use dilators from cook sheath to dilate tract prior to valve /sheath insertion

Straight pigtail is for root injections. 2nd pigtail is used to remove safari wire post-valve deployment

Not DD or CS

Call Echo

• Micropuncture
• 75 Amplatz SS
• Pericardiocentesis tray
• Accordion drain bag

Spies

Call Echo

Supplies:

• Micro puncture
• 150cm J wire
• 4/5fr slender sheath
• 5fr straight pigtail diagnostic
• gravity drainage bag
• brown reservoir lab canister
• Two 50 or 60ml syringes

Daniels

Call Echo

Supplies

Open

Emergency Kit located in each lab containing the following items:

• Eye drape
• Skater introducer set
• Bard locking pigtail (6f or 8f)
• (3) 60ml luer lock syringe
• Amplatz super stiff .035 180cm wire
• Probe cover
• Stopcock
• Accordion drainage bag

Standby

• Chiba biopsy needle 10cm 18g
• Standard .035 150cm j wire

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Approved: MM/YY