Axillary TAVI

Access

7F Pinnacle - Right IJ

7F Slender - Right Radial

7F Slender - Left Radial

8F Arrow - L Axillary

Equipment

• Micropuncture
• 7F Pinnacle
• (2) 7F Slenders
• 8F Arrow
• 12F Dilator
• (2) Perclose
• 5F Angled Pigtail
• 4F Straight Pigtail (on order, will need to use 5F in the meantime)
• 5F AL1
• Runthrough wire
• 0.35 x 260 J Wire
• Safari
• Mustang Balloon of Physicians preference (Most likely an 8)
• Indeflator for mustang

Procedural Steps

If anesthesia needs an A-line for induction we will upsize for procedure (they will have access to contralateral radial artery) Obtain all access points as listed above, most likely starting with the IJ.

5F Pigtail advanced from the left radial, subclavian angiography performed. Micropuncture with ultrasound, fluoro and pigtail guidance.

Pre-close x 2. 8F arrow sheath advanced.

4F pigtail advanced from R Radial, root shot performed

AL1 advanced from the L Radial for valve crossing in standard fashion.

Pigtail to LV, exchanged for Safari.

12F dilator in and out, E Sheath advanced.

Valve advanced and deployed.

Delivery removed and runthrough and mustang advanced to the sublcavian for tamponade during access closure.

DSA.

TR bands and go home.