TAVI-JenaValve: Difference between revisions

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{{Note|Ensure Milena and the research team is in the lab at the time the patient enters the lab. This is to expedite the valve prep. }}
{{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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'''ACIST A1000V SYRINGE USED WITH 50/50 CONTRAST MIX'''
'''ACIST A1000V SYRINGE USED WITH 50/50 CONTRAST MIX'''


'''As of 12/11 we will now pace for ALL Jenavalve implants.'''
'''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.'''  
'''Anesthesia- MAC is our new standard. Have ICU on standby.'''  
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*6Fr x 10cm sheath
*6Fr x 10cm sheath
*8Fr x 10 cm sheath  
*8Fr x 10 cm sheath  
*18F Cook Sheath- on standby
*18F Cook Sheath *** On standby


===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
*1 L warm saline (on standby)
*1 L warm saline (on standby)
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*(3) Perclose
*(3) Perclose
*(5) bowls (cold saline in all 5 * NO need for contrast mix on back table *)  
*(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)  
*Suture removal kit (for back table)  


===On Standby : Transvenous pacemaker supplies===
===Transvenous pacemaker supplies===


*8F Brite tip Sheath
*8F Brite tip Sheath
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===PROCEDURAL INFO:===
===PROCEDURAL INFO:===


*Standard TAVR access.
*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.
*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 (when ACT above 250)
*JV Guide sheath inserted (when ACT above 250)
*Delivery system attached to pressure bag via co-pilot on front table.
*Delivery system attached to pressure bag via co-pilot on front table.
*Valve inserted and deployed
*Valve inserted and deployed
*Delivery system pulled back into JVsheath
*Delivery system pulled back into JV sheath
*Possible exchange for 18F if concern about pulling safari through/BAV needed
*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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