TAVI-JenaValve: Difference between revisions

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{{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. }}
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==Daniels/Spies - Draft==
==Daniels/Spies - Draft==
'''ACIST A1000V SYRINGE USED WITH 50/50 CONTRAST MIX'''
'''ACIST A1000V SYRINGE USED WITH 50/50 CONTRAST MIX'''


'''If patient has permanent pacer, no need for TVP. Pacing is only used for backup (not deployment).'''
'''Bipolar Pacing for ALL Jenavalve implants. (Because JenaValve sheath doesn't allow for electrical conduction.)'''  


'''Anesthesia- GA is standard. May consider MAC based on patient.  If MAC, may want ICE.'''
'''Anesthesia- MAC is our new standard. Have ICU on standby.'''  


===Sheaths:===
===Sheaths:===
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*5Fr Micropunture Kit
*5Fr Micropunture Kit
*6Fr x 10cm sheath
*6Fr x 10cm sheath
*8Fr x 10 cm sheath (Dilator used only)
*8Fr x 10 cm sheath  
*8Fr x 35 cm Brite Tip Sheath
*18F Cook Sheath *** On standby
*18F Cook Sheath- on standby in case of BAV


===Wires:===
===Wires:===
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*Cordis 260J
*Cordis 260J
*Safari 2
*Safari 2
*Lunderquist *** On Standby


===Catheters:===
===Catheters:===


*5Fr MPA
*5Fr MPA
*5Fr Angled Pigtail
*5F MBP *** On standby
*5F MBP on standby
*5F & 6F Angled Pigtail
*6F Marker Pigtail *** ASK BEFORE OPENING (From IR . If you only have a 5F drop PSI to 400.)


===Medications on table:===
===Medications on table:===
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===Miscellaneous Supplies===
===Miscellaneous Supplies===


*3-port manifold kit
*3-port manifold kit (only if shooting coronaries)
*Acist hand control
*Acist hand control
*3L cold saline
*1 L warm saline (on standby)
*1L warm saline
*3 L cold saline
*(2) 60ml syringes
*(2) 60ml syringes (for back table)
*(2) 20ml syringes
*(2) 20ml syringes (one for back table one for front)
*stopcock
*stopcock (for back table)
*co-pilot
*co-pilot (for back table)
*108cm tubing
*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
*500ml hep saline on pressure bag for delivery system
*(3) Perclose
*(3) Perclose
*(5) bowls
*(5) bowls (cold saline in all 5 * NO need for contrast mix on back table *)
*Suture removal kit (for back table)


===Transvenous pacemaker supplies===
===Transvenous pacemaker supplies===


*8F Brite tip Sheath
*5Fr Josephson Pacing catheter
*5Fr Josephson Pacing catheter
*Dual Red/Black Pacing Remington cables
*Dual Red/Black Pacing Remington cables
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===PROCEDURAL INFO:===
===PROCEDURAL INFO:===


*Standard TAVR access. NO V IF PT HAS PACEMAKER.
*Standard TAVR access. (Jenavalve sheath is 20F)
*Pigtail in contralateral access, injection for coplanar angle.
*Pigtail in contralateral access, injection for coplanar angle.
*Change injector to 10/10 after coplanar angle established.
*Pigtail exchanged for MPA
*Pigtail exchanged for MPA
*Pigtail advanced on primary side for valve crossing over J wire
*Pigtail advanced on primary side for valve crossing over J wire
*Jwire exchanged for Safari and pigtail removed
*J-wire exchanged for Safari and pigtail removed
*JV Guide sheath inserted
*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 JV sheath
*Possible exchange for 18F sheath, re-advance the MP to remove the safari


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  [[Category:Procedures]]
  [[Category:Procedures]]

Latest revision as of 20:48, 27 July 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

Bipolar Pacing for ALL Jenavalve implants. (Because JenaValve sheath doesn't allow for electrical conduction.)

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 *** On Standby

Catheters:

  • 5Fr MPA
  • 5F MBP *** On standby
  • 5F & 6F Angled Pigtail
  • 6F Marker Pigtail *** ASK BEFORE OPENING (From IR . If you only have a 5F drop PSI 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 *)
  • Suture removal kit (for back table)

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. (Jenavalve sheath is 20F)
  • 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
  • J-wire 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 JV sheath
  • Possible exchange for 18F sheath, re-advance the MP to remove the safari


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