BASILICA: Difference between revisions

From Bay Area Structural Heart Wiki
(current standards)
No edit summary
Line 10: Line 10:
*.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 AL2 (for LCA BASILICA)  -OR- 6 FR PJR4 Guide (For RCA BASILICA)
*7 Fr AL2 (for LCA BASILICA)  -OR- 7F MP1 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 29: Line 29:
*Gooseneck snares 25, 30mm
*Gooseneck snares 25, 30mm
*.035 QuickCross
*.035 QuickCross
*AL2, AL3, EBU4, EBU 3.75 (Left leaflet)
*AL2, AL3, AL4,  EBU4, EBU 3.75 (Left leaflet)
*MPA1, JR4, IM, AR1 (Right leaflet)
*MPA1, JR4, IM, AR1 (Right leaflet)



Revision as of 18:25, 24 March 2021

(Bioprosthetic Aortic Scallop Intentional Laceration to prevent Iatrogenic Coronary Artery obstruction)

ACC.org BASILICA Page

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
  • 7 Fr AL2 (for LCA BASILICA) -OR- 7F MP1 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, AL4, 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