Tricuspid Clip: Difference between revisions
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*ICE on standby | *ICE on standby | ||
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4F Venous sheath LFV for ACT's and potential ICE access | *LFV primary access | ||
*4F Venous sheath LFV for ACT's and potential ICE access | |||
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*80 cm from sub-xyphoid, or | *80 cm from sub-xyphoid, or | ||
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*ICE 8fr. and SwiftLink cover | *ICE 8fr. and SwiftLink cover | ||
**9fr x 23cm Pinnacle for ICE | **9fr x 23cm Pinnacle for ICE | ||
*150cm J wire | |||
===Wires:=== | ===Wires:=== | ||
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====Open==== | ====Open==== | ||
*Amplatz SS 7cm | *Amplatz SS 7cm x 260 | ||
===Misc supplies:=== | ===Misc supplies:=== | ||
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===Non-Sterile Supplies=== | ===Non-Sterile Supplies=== | ||
*'''Set-up 2 IV poles to facilitate quick device changeover.''' | |||
*(4) Liter bags of heparinized saline | *(4) Liter bags of heparinized saline | ||
*(4) Liter sized pressure bags | *(4) Liter sized pressure bags | ||
Revision as of 18:07, 17 December 2020
DRAFT
| Tricuspid Clip | |||||
|---|---|---|---|---|---|
| Anesthesia | Imaging | Access | Pre-Procedure | ||
| General |
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Big Equipment:
Open
- Cath pack
- Lift / Footstool / Support base
- Clear Plexiglass base support
- Sterile System Stabilizer
Standby
- ICE 8fr. and SwiftLink cover
- 9fr x 23cm Pinnacle for ICE
- 150cm J wire
Wires:
Open
- Amplatz SS 7cm x 260
Misc supplies:
Open
- (4) 108cm High pressure IV Lines
- (8) Stopcocks
- 8F Sheath for dilator - (also used as a backup sheath)
- (1)Perclose
- 4-0 Vicryl/monocryl
- Pickups (Either from a suture removal kit or individual from SPD)
- (2) 60cc syringe
- 12” extension (Keep stickers to label flush tubing)
- Sterile towel pack for back table
- Fluoro cover to anesthesia IV pole or moving xray shield
- 20F Dilator
- Micropuncture
- U/S probe cover
- 3 Port Manifold to record Pre/Post RA pressures
Standby
- Additional Perclose
- Pericardiocentesis supplies
Non-Sterile Supplies
- Set-up 2 IV poles to facilitate quick device changeover.
- (4) Liter bags of heparinized saline
- (4) Liter sized pressure bags
Procedure
- Anesthesia will obtain radial art line prior to draping.
- Pre procedure TEE imaging performed
- Prior to prepping patient, place MitraClip Plate (plexiglass board – hinge side up) under patient’s leg off center to the right. Place MitralClip Lift (step stool) over patients right leg, angled down towards the head. Measure 80cm from subxyphoid, or 85 from mid-sternum to leading edge of stool. Make sure there is direct contact between stool and plate.
- Prep patient and drape per usual. Drape anesthesia pole and/or xray shield.
- Obtain RFV access, dilate with 8F, preclose. .035 wire inserted into perclose.
- Amplatz SS advanced through perclose to RV
- 20F dilator inserted and removed
- MitraClip Guide inserted.
- Setup stabilizer and silicone sheet. Hand MD 60ml syringe with short extension tubing for aspiration.
- Amplatz wire and dilator removed. Clip inserted.
- Drips should be maintained at 1 drip every 3 seconds. If bubbles are seen on echo, turn drips down.
- When clip is being deployed turn room lights up and drips up. Place bowl below to catch drips while deploying.
- Hand MD 60ml syringe with extension tubing for aspiration while delivery system is removed.
- Vicryl used for groin closure
Off Label Tricuspid Clip Notes
- Left femoral venous access (height and septal hugger)
- Guide upside down to start
- 180 degree mis key, blue line at 11 o clock
- Steer down with A "A is F"
- "Negative is L"
- Create a septal hugger by adding M
- Rotation of clip Counter clockwise to decrease septal hugger
BACK TABLE SETUP
- 108" Tubing spikes handed off to circulator, keep rollers on sterile field.
- Follow Rep instructions for device prep.
APPROVED: MD initials MM/YY
