TAVI-JenaValve: Difference between revisions

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Revision as of 15:24, 24 January 2023

Note Note: Ensure Milena and the research team are in the lab at the time the patient enters the room. This is to expedite the valve prep.


Daniels/Spies - Draft

ACIST A1000V SYRINGE USED WITH 50/50 CONTRAST MIX

As of 12/11 we will now pace for ALL Jenavalve implants.

Anesthesia- MAC is our new standard. Have ICU on standby.

Sheaths:

  • 5Fr Micropunture Kit
  • 6Fr x 10cm sheath
  • 8Fr x 10 cm sheath
  • 18F Cook Sheath- on standby

Wires:

  • (2) Cordis 150J
  • Cordis 260J
  • Safari 2
  • Lunderquist for guide advancement

Catheters:

  • 5Fr MPA
  • 5Fr Angled Pigtail
  • 5F MBP on standby
  • 6F Marker Pigtail (From IR . If you only have a 5F drop PCI to 400.)

Medications on table:

  • Lido/Bupivicaine 50/50
  • Epinephrine 10mcg/ml in red medallion syringe (From anesthesia)

Miscellaneous Supplies

  • 3-port manifold kit (only if shooting coronaries)
  • Acist hand control
  • 1 L warm saline (on standby)
  • 3 L cold saline
  • (2) 60ml syringes (for back table)
  • (2) 20ml syringes (one for back table one for front)
  • stopcock (for back table)
  • co-pilot (for back table)
  • Roto-tubing (for back table, will be tossed over from table and spiked in pressure bag of hep saline)
  • 500ml hep saline on pressure bag for delivery system
  • (3) Perclose
  • (5) bowls (cold saline in all 5 * NO need for contrast mix on back table *)
  • Alligator pacer cable (Unipolar pacing)
  • Suture removal kit (for back table)

On Standby : Transvenous pacemaker supplies

  • 8F Brite tip Sheath
  • 5Fr Josephson Pacing catheter
  • Dual Red/Black Pacing Remington cables
  • EP Quad Cable

PROCEDURAL INFO:

  • Standard TAVR access.
  • Pigtail in contralateral access, injection for coplanar angle.
  • Change injector to 10/10 after coplanar angle established.
  • Pigtail exchanged for MPA
  • Pigtail advanced on primary side for valve crossing over J wire
  • Jwire exchanged for Safari and pigtail removed
  • JV Guide sheath inserted (when ACT above 250)
  • Delivery system attached to pressure bag via co-pilot on front table.
  • Valve inserted and deployed
  • Delivery system pulled back into JVsheath
  • Possible exchange for 18F sheath, re-advance the MP to remove the safari