ASD Closure: Difference between revisions

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=='''DR. Daniels''' - DRAFT==


'''RFV access, GENERAL ANESTHESIA with TEE'''


===Medications:===


'''ASD Closure'''
*Pre-Op Antibiotics : Ancef IV
*Antiplatelet : Aspirin & Plavix


'''DR. WALSH'''
====Open====


RFV access, GENERAL ANESTHESIA with TEE
*5Fr Micropuncture  Kit
*8fr Pinnacle
*12F Cook Sheath
*0.035 x 260 Rosen
*J Wire 0.035 x 260
*5Fr MPA 100 cm diagnostic
*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
 
====Standby====
 
*4 Fr x 10 cm Pinnacle (possible femoral arterial line for anesthesia
 
*0.035 x 250 Amplatz Super Stiff 1cm tip
*BMW 190cm
*Wholey 145cm
*Cordis “J” 0.032 x 260 cm
 
===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===
 
#Access with micropuncture and ultrasound
#8fr sheath (might pre-close)
#MP with Rosen to cross ASD
#Exchange Rosen for 260J to LUPV
#Possible sizing balloon used here
#Prep and deliver device
 
=='''DR. Spies''' - DRAFT==
RFV access.  (x2 if using ICE)
 
Medications:
 
*Pre-Op Antibiotics : Ancef IV
*Antiplatelet : Aspirin & Plavix
 
====Open====
*5Fr Micropuncture  Kit  
*8fr Pinnacle (for preclose dilation)
*.035 Amplatz '''Extra Stiff'''
*.035 Exchange J
*5Fr MPA 100 cm diagnostic
*0-Prolene for woggle or tie at end
*Large Sterile Bowl with 1L Heparinized Saline for Device Prep USE ONLY
*'''10% Contrast mix for sizing balloon'''
*60 ml syringe
*9F 25cm Brite Tip if using ICE
*SwiftLink (ICE)
*8F Accunav (ICE)
 
====Standby====
*8F TorqVue
*24 Sizing balloon
*6F Balloon Wedge
*Stopcock
*3-port manifold
 
===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)


Sheaths:
==== Procedure: ====


* 1 5Fr Micropunture  Kit  
* Access with US and Micropuncture
* 1 8Fr x 23 Brite Tip Sheath for RFV access
* 8F Sheath inserted possible 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


Standby Item:
<HR />


* 4 Fr x 10 cm Pinnacle (possible femoral arterial line for anesthesia)
== '''Dr. Groves''' ==
'''RFV access, GENERAL ANESTHESIA with TEE'''


Vascular Closure Device
Medications:


* 1 6Fr Perclose RFV
*Pre-Op Antibiotics : Ancef IV
*Antiplatelet : Aspirin & Plavix


Wires:
====Open====
*5Fr Micropuncture  Kit  
*8fr Pinnacle (for preclose dilation)
*.035 Amplatz '''Extra Stiff'''
*.035 150J
*5Fr MPA 100 cm diagnostic
*0-Prolene for woggle or tie at end
*Large Sterile Bowl with 1L Heparinized Saline for Device Prep USE ONLY
*'''10% Contrast mix for sizing balloon'''
*60 ml syringe


* 0.035 x 250 Amplatz Straight Tip Super Stiff
*9F 25cm Brite Tip if using ICE
* Cordis “J” Wire 0.035 x 150cm
*SwiftLink (ICE)
*8F Accunav (ICE)


Standby Items:
====Standby====
*8F TorqVue
*24 Sizing balloon
*6F Balloon Wedge
*Stopcock
*3-port manifold
*50mL Syringe


* BMW 190cm
==== Procedure: ====
* Versacore 145cm
* Cordis “J” 0.035 x 260 cm
* Amplatzer Guide 0.035 x 260 cm


Catheters:
* Access with US and Micropuncture
* 8F Sheath inserted possible 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


* 6Fr MPA 100 cm diagnostic
<br />
* Right Heart Catheter: 5Fr Arrow Wedge Swan


TEE guidance & General Anesthesia


* 2 Lead shield
=='''DR. Hui''' - DRAFT==
RFV access, GENERAL ANESTHESIA with TEE


Medications:
Medications:


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


1 Maniford Set Up: NO ACIST
===Sheaths:===


* 1 3 - Manifold
====Open====
* 1 200 ml Visipaque Contrast
* 1 CG8 istat for PA sat
* 1 25g  1 ½ “ Daniels Femoral Needle


Device Table
*5Fr Micropuncture  Kit  
*6fr pinnacle for RFV access


* 1 Large Sterile Bowl with 1L Heparinized Saline for Device Prep USE ONLY
====Standby====
* 3 packs of sterile towels
* 1 bowl with 20% contrast/80% saline for Sizing Balloon prep
* 1 60 ml syringe
* 2 20 ml syringe


*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
Amplatzer Supplies & Occluder Devices: OPEN WHEN MD REQUESTS


* Sizing Balloon (Range: 18, 24, 34mm)
*Sizing Balloon (Range: 18, 24, 34mm)
* TorqVue Delivery Sheath (Range: 7, 8, 9, 10, 12Fr)
*TorqVue Delivery Sheath (Range: 7, 8, 9, 10, 12Fr)
* Device = SEPTAL OCCLUDERS (Range: 10, 11, 12, 13, 15mm)
*Device = SEPTAL OCCLUDERS (All available sizes)
 
===Device Thrombosis/Retrieval Supplies===


Emergency Supplies
*16 or 18 Fr Dry Seal Sheath
*6 or 7 Fr Ensnare Kit or Gooseneck Snare


* Pericardiocentesis Tray
<BR />
* Pericardiocentesis Supplies:
<hr />
** 5Fr VS Micropuncture
Approved: MM/YY
** Dilators
** 0.035 J Wire 150 cm
** 60 ml syringe
** Pericardiocentesis drainage bag
** Bard Pigtail drainage catheter size per MD request


Emergency  Device dislodgement/retrieval Supplies
[[Category:Procedures]]


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


[[Category:Procedures]]
[[Category:Procedures]]
 
<HR />
APPROVED: MD initials MM/YY
APPROVED: MD initials MM/YY

Latest revision as of 20:40, 7 July 2022

DR. Daniels - DRAFT

RFV access, GENERAL ANESTHESIA with TEE

Medications:

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

Open

  • 5Fr Micropuncture Kit
  • 8fr Pinnacle
  • 12F Cook Sheath
  • 0.035 x 260 Rosen
  • J Wire 0.035 x 260
  • 5Fr MPA 100 cm diagnostic
  • 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

Standby

  • 4 Fr x 10 cm Pinnacle (possible femoral arterial line for anesthesia
  • 0.035 x 250 Amplatz Super Stiff 1cm tip
  • BMW 190cm
  • Wholey 145cm
  • Cordis “J” 0.032 x 260 cm

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

DR. Spies - DRAFT

RFV access. (x2 if using ICE)

Medications:

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

Open

  • 5Fr Micropuncture  Kit  
  • 8fr Pinnacle (for preclose dilation)
  • .035 Amplatz Extra Stiff
  • .035 Exchange J
  • 5Fr MPA 100 cm diagnostic
  • 0-Prolene for woggle or tie at end
  • Large Sterile Bowl with 1L Heparinized Saline for Device Prep USE ONLY
  • 10% Contrast mix for sizing balloon
  • 60 ml syringe
  • 9F 25cm Brite Tip if using ICE
  • SwiftLink (ICE)
  • 8F Accunav (ICE)

Standby

  • 8F TorqVue
  • 24 Sizing balloon
  • 6F Balloon Wedge
  • Stopcock
  • 3-port manifold

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 possible 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

Dr. Groves

RFV access, GENERAL ANESTHESIA with TEE

Medications:

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

Open

  • 5Fr Micropuncture  Kit  
  • 8fr Pinnacle (for preclose dilation)
  • .035 Amplatz Extra Stiff
  • .035 150J
  • 5Fr MPA 100 cm diagnostic
  • 0-Prolene for woggle or tie at end
  • Large Sterile Bowl with 1L Heparinized Saline for Device Prep USE ONLY
  • 10% Contrast mix for sizing balloon
  • 60 ml syringe
  • 9F 25cm Brite Tip if using ICE
  • SwiftLink (ICE)
  • 8F Accunav (ICE)

Standby

  • 8F TorqVue
  • 24 Sizing balloon
  • 6F Balloon Wedge
  • Stopcock
  • 3-port manifold
  • 50mL Syringe

Procedure:

  • Access with US and Micropuncture
  • 8F Sheath inserted possible 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



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)

Device Thrombosis/Retrieval Supplies

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


Approved: MM/YY

APPROVED: MD initials MM/YY

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