David Daniels M.D.: Difference between revisions
From Bay Area Structural Heart Wiki
(updated AS eval equipment when no Langston) |
No edit summary |
||
| Line 10: | Line 10: | ||
}} | }} | ||
==Notes:== | ==Notes:== | ||
===LHC for Renal Transplant=== | |||
*Femoral access | |||
*U/S probe cover | |||
*Micropuncture | |||
*6frx10cm Pinnacle sheath | |||
*6fr. JL4 guide | |||
*6fr. JR4 guide | |||
*Runthrough | |||
*.035x150 J | |||
*Perclose | |||
*ACIST setup | |||
*Biplane | |||
{{Protip|Make sure arms and armboards are tucked-in as much as possible!}} | |||
====Sequence=== | |||
#Access with Micropuncture and U/s. | |||
#JL4 - trade out J-wire for Runthrough. | |||
#Isocenter | |||
#He will use Runthrough to confirm engagement. | |||
#4 for 6 on the ACIST, once he fills the guide note the contrast count. This is zero. | |||
#Biplane to RAO/Cranial and LAO/Caudal | |||
#Take the shot | |||
#Exchange L4 for R4 | |||
#2 for 3 on the ACIST | |||
#Same as Left for engagement and contrast. | |||
#Perclose | |||
===CTO=== | ===CTO=== | ||
*Preclose | *Preclose | ||
*8fr. x 45 Brite Tip sheath | *8fr. x 45 Brite Tip sheath | ||
| Line 27: | Line 53: | ||
===FFR=== | ===FFR=== | ||
*Adenosine IC 10 mcg/ml concentration | *Adenosine IC 10 mcg/ml concentration | ||
===Post Heart Transplant LHC/IVUS with DD=== | ===Post Heart Transplant LHC/IVUS with DD=== | ||
*4/5 Glide Sheath | *4/5 Glide Sheath | ||
*5F JR4 Diagnostic | *5F JR4 Diagnostic | ||
| Line 41: | Line 65: | ||
===R/L Heart for AS no Langston=== | ===R/L Heart for AS no Langston=== | ||
*Micropuncture | *Micropuncture | ||
*7F 90cm Shuttle Sheath | *7F 90cm Shuttle Sheath | ||
| Line 53: | Line 76: | ||
*5fr AL1 | *5fr AL1 | ||
*Exchange length J wire | *Exchange length J wire | ||
===Radial with Eaucath=== | ===Radial with Eaucath=== | ||
*Eaucath | *Eaucath | ||
*His blue angiocath | *His blue angiocath | ||
*Micropuncture set | *Micropuncture set | ||
*260 J-wire | *260 J-wire | ||
====Sequence==== | ====Sequence==== | ||
#Access with angiocath | #Access with angiocath | ||
#MP wire | #MP wire | ||
| Line 77: | Line 95: | ||
<br /> | <br /> | ||
===R/L Heart for AS with Langston=== | ===R/L Heart for AS with Langston=== | ||
*2x 5/6 slender radial sheaths with angiocath | *2x 5/6 slender radial sheaths with angiocath | ||
**(Santa Rosa)1 7 Fr slender radial sheath with angiocath, 1 6 Fr Prelude sheath with stiff micropuncture set | **(Santa Rosa)1 7 Fr slender radial sheath with angiocath, 1 6 Fr Prelude sheath with stiff micropuncture set | ||
| Line 88: | Line 105: | ||
*5fr AL1 | *5fr AL1 | ||
*Exchange length J wire | *Exchange length J wire | ||
====Sequence==== | ====Sequence==== | ||
#Access ultrasound guided vein | #Access ultrasound guided vein | ||
#Standard Radial access | #Standard Radial access | ||
Revision as of 21:24, 10 February 2021
| Glove size | 7 |
|---|---|
| Access |
|
| Radial Setup |
|
| Radial Cocktail |
|
| Groin Setup |
|
| Closure Device |
|
| Right Heart Setup |
|
| Intervention Setup | |
| Phone Number | 1-415-385-9243 |
| Pager Number |
Notes:
LHC for Renal Transplant
- Femoral access
- U/S probe cover
- Micropuncture
- 6frx10cm Pinnacle sheath
- 6fr. JL4 guide
- 6fr. JR4 guide
- Runthrough
- .035x150 J
- Perclose
- ACIST setup
- Biplane
Protip: Make sure arms and armboards are tucked-in as much as possible!
=Sequence
- Access with Micropuncture and U/s.
- JL4 - trade out J-wire for Runthrough.
- Isocenter
- He will use Runthrough to confirm engagement.
- 4 for 6 on the ACIST, once he fills the guide note the contrast count. This is zero.
- Biplane to RAO/Cranial and LAO/Caudal
- Take the shot
- Exchange L4 for R4
- 2 for 3 on the ACIST
- Same as Left for engagement and contrast.
- Perclose
CTO
- Preclose
- 8fr. x 45 Brite Tip sheath
- Assume bilateral groins
- ACIST and 3-port manifold
- Watchdogs
- Retrograde channel on McKesson in red.
- Left groin will have retrograde guide.
- Right groin will have antegrade guide
FFR
- Adenosine IC 10 mcg/ml concentration
Post Heart Transplant LHC/IVUS with DD
- 4/5 Glide Sheath
- 5F JR4 Diagnostic
- 5F EBU3.5
- Runthrough
- IVUS
R/L Heart for AS no Langston
- Micropuncture
- 7F 90cm Shuttle Sheath
- 5F 125cm pigtail
- 6F 10cm pinnacle
- 2x manifold transducers
- Dr. is OK with using a manifold for the case, no ACIST necessary
- 6fr. PA catheter
- 5F JL4/JR4
- Short straight stiff glidewire for valve crossing
- 5fr AL1
- Exchange length J wire
Radial with Eaucath
- Eaucath
- His blue angiocath
- Micropuncture set
- 260 J-wire
Sequence
- Access with angiocath
- MP wire
- MP sheath
- Radial drugs
- 260J-wire
- Eaucath
R/L Heart for AS with Langston
- 2x 5/6 slender radial sheaths with angiocath
- (Santa Rosa)1 7 Fr slender radial sheath with angiocath, 1 6 Fr Prelude sheath with stiff micropuncture set
- 2x manifold transducers
- Dr. is OK with using a manifold for the case, no ACIST necessary
- 6fr. PA catheter
- 5fr. Tig
- 7fr. Langston catheter
- Short straight stiff glidewire
- 5fr AL1
- Exchange length J wire
Sequence
- Access ultrasound guided vein
- Standard Radial access
- PA catheter for pressures
- Tig for cors
- Exchange over long wire Tig for AL1
- J out for Glidewire
- Cross valve
- Exchange over long wire AL1 for Langston
- Use standard transducers for accuracy, do not use ACIST
