ASD Closure: Difference between revisions

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<HR />
<HR />
APPROVED: MD initials MM/YY


=='''DR. Spies''' - DRAFT==
=='''DR. Spies''' - DRAFT==
RFV access, GENERAL ANESTHESIA with TEE
RFV access.  (x2 if using ICE)


Medications:
Medications:
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*Pre-Op Antibiotics : Ancef IV
*Pre-Op Antibiotics : Ancef IV
*Antiplatelet : Aspirin & Plavix
*Antiplatelet : Aspirin & Plavix
===Sheaths:===


====Open====
====Open====


*Perclose vs 0-Prolene for closure (ask MD)
*5Fr Micropuncture  Kit  
*5Fr Micropuncture  Kit  
*8fr Pinnacle (for preclose dilation)
*8fr Pinnacle (for preclose dilation)
 
*.035 Amplatz Extra Stiff
====Standby====
*.035 Exchange J
 
*4 Fr x 10 cm Pinnacle (possible femoral arterial line for anesthesia
 
===Wires:===
 
====Open====
 
*0.035 x 250 Amplatz Super Stiff 1cm tip
*.032x 260 J wire
 
====Standby====
 
*BMW 190cm
*Wholey 145cm
*Cordis “J” 0.035 x 260 cm
*Amplatzer Guide 0.035 x 260 cm
 
===Catheters:===
 
====Open====


*5Fr MPA 100 cm diagnostic
*5Fr MPA 100 cm diagnostic
 
*6F Balloon Wedge
===Misc. Supplies:===
*Stopcock


*3-port manifold
*3-port manifold
*Perclose


*Large Sterile Bowl with 1L Heparinized Saline for Device Prep USE ONLY
*Large Sterile Bowl with 1L Heparinized Saline for Device Prep USE ONLY
*(3)packs of sterile towels
*15% Contrast mix for sizing balloon
*1 bowl with 20% contrast/80% saline for Sizing Balloon prep
*60 ml syringe
*60 ml syringe
*(2) 20 ml syringe
*(2) 20 ml syringe
****9F 25cm Brite Tip if using ICE
****SwiftLink (ICE)
****8F Accunav (ICE)


===Devices on standby:===
===Devices on standby:===
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*Device = SEPTAL OCCLUDERS (All available sizes)
*Device = SEPTAL OCCLUDERS (All available sizes)


Cardioform devices - '''If needing to deliver cardioform sheath, use a 7F shuttle sheath dilator.'''
==== Procedure: ====
 
* Access with US and Micropuncture
* 8F Sheath inserted and RHC performed with 6F Balloon Wedge
* (If Using) ICE catheter inserted, bubble study performed
* MPA and J wire advanced across septum
* J wire exchanged for Amplatz ES
* Sizing balloon inserted
* Measurements taken on x-ray image
* ASD closed
* Insertion sites closed


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Revision as of 17:58, 4 February 2021

DR. Daniels - DRAFT

RFV access, GENERAL ANESTHESIA with TEE

Medications:

  • Pre-Op Antibiotics : Ancef IV
  • Antiplatelet : Aspirin & Plavix

Sheaths:

Open

  • 5Fr Micropuncture Kit
  • 8fr Pinnacle

Standby

  • 4 Fr x 10 cm Pinnacle (possible femoral arterial line for anesthesia

Wires:

Open

  • 0.035 x 260 Rosen
  • J Wire 0.035 x 260

Standby

  • 0.035 x 250 Amplatz Super Stiff 1cm tip
  • BMW 190cm
  • Wholey 145cm
  • Cordis “J” 0.032 x 260 cm

Catheters:

Open

  • 5Fr MPA 100 cm diagnostic

Misc. Supplies:

  • 3-port manifold
  • Large Sterile Bowl with 1L Heparinized Saline for Device Prep USE ONLY
  • 1 bowl with 20% contrast/80% saline for Sizing Balloon prep
  • 60 ml syringe
  • 20 ml syringe

Devices on standby:

  • Amplatzer Supplies & Occluder Devices: OPEN WHEN MD REQUESTS
  • Perclose
  • Sizing Balloon (Range: 18, 24, 34mm)
  • TorqVue Delivery Sheath (Range: 7, 8, 9, 10, 12Fr)
  • Device = SEPTAL OCCLUDERS (All available sizes)
  • Cardioform devices - If needing to deliver cardioform sheath, use a 7F shuttle sheath dilator.

Procedure

  1. Access with micropuncture and ultrasound
  2. 8fr sheath (might pre-close)
  3. MP with Rosen to cross ASD
  4. Exchange Rosen for 260J to LUPV
  5. Possible sizing balloon used here
  6. Prep and deliver device


Pericardiocentesis

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

Emergency Device embolization/retrieval Supplies:

  • 16 or 18 Fr x 33 cm Dry Seal Sheath
  • 6 or 7 Fr Ensnare Kit or Gooseneck Snare

DR. Spies - DRAFT

RFV access. (x2 if using ICE)

Medications:

  • Pre-Op Antibiotics : Ancef IV
  • Antiplatelet : Aspirin & Plavix

Open

  • Perclose vs 0-Prolene for closure (ask MD)
  • 5Fr Micropuncture  Kit  
  • 8fr Pinnacle (for preclose dilation)
  • .035 Amplatz Extra Stiff
  • .035 Exchange J
  • 5Fr MPA 100 cm diagnostic
  • 6F Balloon Wedge
  • Stopcock
  • 3-port manifold
  • Large Sterile Bowl with 1L Heparinized Saline for Device Prep USE ONLY
  • 15% Contrast mix for sizing balloon
  • 60 ml syringe
  • (2) 20 ml syringe
        • 9F 25cm Brite Tip if using ICE
        • SwiftLink (ICE)
        • 8F Accunav (ICE)

Devices on standby:

Amplatzer Supplies & Occluder Devices: OPEN WHEN MD REQUESTS

  • Sizing Balloon (Range: 18, 24, 34mm)
  • TorqVue Delivery Sheath (Range: 7, 8, 9, 10, 12Fr)
  • Device = SEPTAL OCCLUDERS (All available sizes)

Procedure:

  • Access with US and Micropuncture
  • 8F Sheath inserted and RHC performed with 6F Balloon Wedge
  • (If Using) ICE catheter inserted, bubble study performed
  • MPA and J wire advanced across septum
  • J wire exchanged for Amplatz ES
  • Sizing balloon inserted
  • Measurements taken on x-ray image
  • ASD closed
  • Insertion sites closed


Pericardiocentesis

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

Emergency Device embolization/retrieval Supplies:

  • 16 or 18 Fr x 33 cm Dry Seal Sheath
  • 6 or 7 Fr Ensnare Kit or Gooseneck Snare



APPROVED: MD initials MM/YY



DR. Hui - DRAFT

RFV access, GENERAL ANESTHESIA with TEE

Medications:

  • Pre-Op Antibiotics : Ancef IV
  • Antiplatelet : Aspirin & Plavix

Sheaths:

Open

  • 5Fr Micropuncture  Kit  
  • 6fr pinnacle for RFV access

Standby

  • 4 Fr x 10 cm Pinnacle (possible femoral arterial line for anesthesia

Wires:

Open

  • 0.035 x 250 Amplatz Straight Tip Super Stiff
  • Cordis “J” Wire 0.035 x 150cm

Standby

  • BMW 190cm
  • Versacore 145cm
  • Cordis “J” 0.035 x 260 cm
  • Amplatzer Guide 0.035 x 260 cm

Catheters:

Open

  • 6Fr MPA 100 cm diagnostic

Misc. Supplies:

  • 3-port manifold with a stopcock on the front
  • Large Sterile Bowl with 1L Heparinized Saline for Device Prep USE ONLY
  • (3)packs of sterile towels
  • 1 bowl with 20% contrast/80% saline for Sizing Balloon prep
  • 60 ml syringe
  • (2) 20 ml syringe

Devices on standby:

Amplatzer Supplies & Occluder Devices: OPEN WHEN MD REQUESTS

  • Sizing Balloon (Range: 18, 24, 34mm)
  • TorqVue Delivery Sheath (Range: 7, 8, 9, 10, 12Fr)
  • Device = SEPTAL OCCLUDERS (All available sizes)

Emergency Supplies:

  • Pericardiocentesis Tray
  • Pericardiocentesis Supplies:
    • 5Fr VS Micropuncture
    • Dilators
    • 0.035 J Wire 150 cm
    • 60 ml syringe
    • Pericardiocentesis drainage bag

Emergency Device embolization/retrieval Supplies:

  • 16 or 18 Fr x 33 cm Dry Seal Sheath
  • 6 or 7 Fr Ensnare Kit or Gooseneck Snare

APPROVED: MD initials MM/YY