TAVI-JenaValve

Daniels/Spies - Draft

ACIST A1000V SYRINGE USED WITH 50/50 CONTRAST MIX

If patient has permanent pacer, no need for TVP. Pacing is only used for backup (not deployment).

Anesthesia- GA is standard. May consider MAC based on patient. If MAC, may want ICE.

Sheaths:

• 5Fr Micropunture Kit
• 6Fr x 10cm sheath
• 8Fr x 10 cm sheath (Dilator used only)
• 8Fr x 35 cm Brite Tip Sheath
• 18F Cook Sheath- on standby

Wires:

• (2) Cordis 150J
• Cordis 260J
• Safari 2

Catheters:

• 5Fr MPA
• 5Fr Angled Pigtail
• 5F MBP on standby

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
• 3L cold saline
• 1L warm saline
• (2) 60ml syringes
• (2) 20ml syringes
• stopcock
• co-pilot
• 108cm tubing
• 500ml hep saline on pressure bag
• (3) Perclose
• (5) bowls

Transvenous pacemaker supplies

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

PROCEDURAL INFO:

• Standard TAVR access. NO V IF PT HAS PACEMAKER.
• Pigtail in contralateral access, injection for coplanar angle.
• Change injector to 10/10 after coplanar angle established.
• Pigtail exchanged for MPA
• Pigtail advanced on primary side for valve crossing over J wire
• Jwire exchanged for Safari and pigtail removed
• JV Guide sheath inserted (when ACT above 250)
• Valve inserted and deployed
• Delivery system pulled back into JVsheath
• Possible exchange for 18F if concern about pulling safari through/BAV needed