Intrepid valve: Difference between revisions
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[[File:Intrepid_supply_list.pdf|thumb|page=1|right|Supply list from Medtronic]] | [[File:Intrepid_supply_list.pdf|thumb|page=1|right|Supply list from Medtronic]] | ||
{{Note| | {{Note|CALL MILENA AS SOON AS PATIENT IS IN THE ROOM!! 415-368-3094}} | ||
[[File:IntrepidTable1.jpg|thumb|150px|right|Intrepid table Setup]] | [[File:IntrepidTable1.jpg|thumb|150px|right|Intrepid table Setup]] | ||
[[File:IntrepidTable2.jpg|thumb|150px|right|Intrepid table Setup]] | [[File:IntrepidTable2.jpg|thumb|150px|right|Intrepid table Setup]] | ||
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*A/V access on opposite side | *A/V access on opposite side | ||
*Monopolar pacing in LV via arterial access with Safari and apical pacing patch | *Monopolar pacing in LV via arterial access with Safari and apical pacing patch | ||
* | *Stool edge is 100cm from mid-sternum | ||
===Open=== | ===Open=== | ||
*TAVR pack | *TAVR pack | ||
| Line 31: | Line 30: | ||
*5fr. JR4 diagnostic catheter | *5fr. JR4 diagnostic catheter | ||
*Safari wire | *Safari wire | ||
*Steelcore wire (10/6/22 DD tested RV pacing, may not need don't drop) | |||
*Watchdog (10/6/22 DD tested RV pacing, may not need don't drop) | |||
*Alligator clip pacing cable (Black clip stays on table; pass off red and plug to circ.) | *Alligator clip pacing cable (Black clip stays on table; pass off red and plug to circ.) | ||
*Perclose | *Perclose | ||
*2 Roto-tubing(for back table) | |||
*2 60ml syringes (for back table) | |||
*2 20ml syringes (for back table) | |||
*Acist setup with 100% contrast for RV or LV gram | |||
===Procedure=== | ===Procedure=== | ||
#Surgical cutdown to RFV | #Surgical cutdown to RFV | ||
#18 gauge entry needle access -> 8fr. Sheath | #LFA access with micropuncture -> 6fr. Sheath | ||
#18 gauge entry needle access -> 8fr. Sheath to RFV | |||
#Maybe Pigtail advanced for RV-gram (Reference image. Lunderquist advanced thru pigtail if used.) | |||
#150 J loaded in JR4 inserted | #150 J loaded in JR4 inserted | ||
#J-wire removed for Lunderquist | #J-wire removed for Lunderquist | ||
#Intrepid sheath inserted over Lunderquist | #Intrepid sheath inserted over Lunderquist | ||
#Manipulate valve to pre-deployment position | #Manipulate valve to pre-deployment position | ||
#150J loaded in JR4 -> LFA to cross Aortic valve | #150J loaded in JR4 -> LFA to cross Aortic valve | ||
Revision as of 17:42, 6 October 2022
File:Intrepid supply list.pdf
Note: CALL MILENA AS SOON AS PATIENT IS IN THE ROOM!! 415-368-3094
Setup Notes
- Reps prep - ~ 1 hour!
- 6 liters cold saline
- Pressure bags x2 for device drips
- Open ECMO tray for reps
- Mitra-clip plate and stool
- Use Coban to attach long table to short table end-to-end to make extra long table(drape first).
- Surgical access
- Neptune and Bovie
- OR setup like carotid
- Cut-down with plegeted purse-string
- A/V access on opposite side
- Monopolar pacing in LV via arterial access with Safari and apical pacing patch
- Stool edge is 100cm from mid-sternum
Open
- TAVR pack
- Back table cover
- 6fr. Pinnacle
- 8fr. Pinnacle
- Micropuncture
- 0.035x150 J-wire
- 5fr. JR4 diagnostic catheter
- Safari wire
- Steelcore wire (10/6/22 DD tested RV pacing, may not need don't drop)
- Watchdog (10/6/22 DD tested RV pacing, may not need don't drop)
- Alligator clip pacing cable (Black clip stays on table; pass off red and plug to circ.)
- Perclose
- 2 Roto-tubing(for back table)
- 2 60ml syringes (for back table)
- 2 20ml syringes (for back table)
- Acist setup with 100% contrast for RV or LV gram
Procedure
- Surgical cutdown to RFV
- LFA access with micropuncture -> 6fr. Sheath
- 18 gauge entry needle access -> 8fr. Sheath to RFV
- Maybe Pigtail advanced for RV-gram (Reference image. Lunderquist advanced thru pigtail if used.)
- 150 J loaded in JR4 inserted
- J-wire removed for Lunderquist
- Intrepid sheath inserted over Lunderquist
- Manipulate valve to pre-deployment position
- 150J loaded in JR4 -> LFA to cross Aortic valve
- J-wire out for Safari
- Safari positioned in LV and alligator clip attached (black to back)
- Pacing threshold tested
- Final positioning of valve and deployed while pacing.
- Safari and JR4 removed
- Intrepid sheath removed and surgically closed
- Perclose to LFA
