BASILICA: Difference between revisions
From Bay Area Structural Heart Wiki
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===Open=== | ===Open=== | ||
*6fr MP1 guide catheter | *Dryseal sheath- size depending on valve, verify with MD before opening. | ||
*6fr MP1 guide catheter | |||
*7F sheath | *7F sheath | ||
*.018 Platinum Plus guidewire 260 cm | *.018 Platinum Plus guidewire 260 cm | ||
*Gooseneck Snare 20mm- '''VERIFY SIZE BEFORE OPENING''' | *Gooseneck Snare 20mm- '''VERIFY SIZE BEFORE OPENING''' | ||
*6 Fr | *6 Fr AL2 (for LCA BASILICA) -OR- 6 FR PJR4 Guide (For RCA BASILICA) | ||
*.014 Astato xs 20 guidewire 180cm | *.014 Astato xs 20 guidewire 180cm | ||
*Piggyback wire converter 4fr x 145 | *Piggyback wire converter 4fr x 145 | ||
| Line 19: | Line 20: | ||
*(2) Stopcocks | *(2) Stopcocks | ||
*4 hemostats | *4 hemostats | ||
*( | *(3) 60ml syringes | ||
*(2) 12 inch extension tubing | *(2) 12 inch extension tubing | ||
*Bowl of D5 | *Bowl of D5 | ||
| Line 25: | Line 26: | ||
===Standby=== | ===Standby=== | ||
* | *Tip deflecting wire | ||
*Gooseneck snares 25, 30mm | *Gooseneck snares 25, 30mm | ||
*.035 QuickCross | *.035 QuickCross | ||
*AL2, AL3, EBU4, EBU 3.75 (Left leaflet) | *AL2, AL3, EBU4, EBU 3.75 (Left leaflet) | ||
*MPA1, JR4, IM, AR1 (Right leaflet) | *MPA1, JR4, IM, AR1 (Right leaflet) | ||
<br /> | <br /> | ||
Revision as of 22:12, 16 February 2021
(Bioprosthetic Aortic Scallop Intentional Laceration to prevent Iatrogenic Coronary Artery obstruction)
Open
- Dryseal sheath- size depending on valve, verify with MD before opening.
- 6fr MP1 guide catheter
- 7F sheath
- .018 Platinum Plus guidewire 260 cm
- Gooseneck Snare 20mm- VERIFY SIZE BEFORE OPENING
- 6 Fr AL2 (for LCA BASILICA) -OR- 6 FR PJR4 Guide (For RCA BASILICA)
- .014 Astato xs 20 guidewire 180cm
- Piggyback wire converter 4fr x 145
- Bovie pen
- Grounding Pad
- Bovie machine
- (2) Watchdog devices
- (2) Stopcocks
- 4 hemostats
- (3) 60ml syringes
- (2) 12 inch extension tubing
- Bowl of D5
Standby
- Tip deflecting wire
- Gooseneck snares 25, 30mm
- .035 QuickCross
- AL2, AL3, EBU4, EBU 3.75 (Left leaflet)
- MPA1, JR4, IM, AR1 (Right leaflet)
Procedure
- Setup and access is the same as TAVR except a 14F Dryseal sheath is inserted initially instead of the ESheath.
- Bovie set at 30 CUT ONLY.
- AL1 advanced over J wire through 7F sheath. Wire exchanged for straight stiff glidewire for valve crossing.
- AL1 exchanged over the wire for MP1 Guide with watchdog and stopcock attached.
- Platinum Plus wire is preshaped by MD and inserted through MP to retain LV access.
- Snare advanced through MP alongside Platinum Plus.
- BASILICA catheter advanced through Dryseal sheath with watchdog and stopcock attached.
- Kinked Astato wire advanced through BASILICA catheter.
- Hand injection performed to verify position of BASILICA catheter.
- Astato wire connected to bovie with 2 hemostats.
- RF applied as Astato wire advanced.
- Once wire penetrates leaflet it is snared and pulled into MP1.
- Platinum Plus wire removed
- Pacing wire advanced and tested
- AL1 advanced next to BASILICA catheter and valve recrossed in standard fashion.
- 60ml D5 filled syringes and extension tubing attached to sideports of guides and injected simultaneously during leaflet laceration.
- MP removed. BASILICA catheter removed.
- Amplatz ES advanced through AL1 and AL1 removed.
- Pigtail advanced to coronary cusp
- Dryseal exchanged for ESheath
- Do a TAVR.
Approved: MM/YY
