David Daniels M.D.: Difference between revisions
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{{Physician | {{Physician | ||
|Glove size=7 | |Glove size=7 *CHECK DD's PROCEDURAL PLAN IN H&P FOR SUPPLIES | ||
|Access=U/s and micropuncture | |Access=U/s and micropuncture | ||
|Radial Setup=4/5 angiocath dx only, 5/6 angiocath pci, Tig4, 260J | |Radial Setup=4/5 angiocath dx only, 5/6 angiocath pci, Tig4, 260J | ||
|Radial Cocktail=200 mcg NTG,2.5mg Verapamil, 60u/kg Heparin | |Radial Cocktail=200 mcg NTG,2.5mg Verapamil, 60u/kg Heparin | ||
|Groin Setup=6fr sheath, JL4 / JR4 | |Groin Setup=6fr sheath, 6Fr JL4 / JR4 | ||
|Closure Device=Perclose | |Closure Device=Perclose | ||
|Right Heart Setup=Manifold, 6fr wedge cath, 5/6 slender angiocath, .035 wire, RN to put brachial IV in, Biopsy - Jaws ALWAYS | |||
|Phone Number=1-415-385-9243 | |Phone Number=1-415-385-9243 | ||
}} | }} | ||
==Notes:== | |||
<br /> | ===LHC for Renal Transplant=== | ||
====See [[Pre-Kidney Heart Cath]]==== | |||
*Femoral access | |||
*U/S probe cover | |||
*Micropuncture | |||
*6frx10cm Pinnacle sheath | |||
*6fr. JL4 guide | |||
*6fr. JR4 guide | |||
*Runthrough | |||
*Co-Pilot | |||
*Wire introducer | |||
*.035x150 J | |||
*Perclose | |||
*ACIST setup | |||
*Biplane | |||
{{Protip|Make sure arms and armboards are tucked-in as much as possible!}} | |||
====Sequence==== | |||
#Access with Micropuncture and U/s. | |||
#JL4 - trade out J-wire for Runthrough. | |||
#Isocenter | |||
#He will use Runthrough to confirm engagement. | |||
#4 for 6 on the ACIST, once he fills the guide note the contrast count. This is zero. | |||
#Biplane to RAO/Cranial and LAO/Caudal | |||
#Take the shot | |||
#Exchange L4 for R4 | |||
#2 for 3 on the ACIST | |||
#Same as Left for engagement and contrast. | |||
#Perclose | |||
===CTO=== | |||
*Preclose | |||
*8fr. x 45 Brite Tip sheath | |||
*Assume bilateral groins | |||
*ACIST and 3-port manifold | |||
*Watchdogs | |||
*Retrograde channel on McKesson in red. | |||
*Left groin will have retrograde guide. | |||
*Right groin will have antegrade guide | |||
===FFR=== | |||
*Adenosine IC 10 mcg/ml concentration | |||
===Post Heart Transplant LHC/IVUS with DD=== | |||
*4/5 Glide Sheath | |||
*5F JR4 Diagnostic | |||
*5F EBU3.5 | |||
*Runthrough | |||
*IVUS | |||
===R/L Heart for AS no Langston=== | |||
*Micropuncture | |||
*7F 70cm Shuttle Sheath or Ansel 70cm | |||
*5F angled pigtail | |||
*6F 10cm pinnacle | |||
*2x manifold transducers | |||
**Dr. is OK with using a manifold for the case, no ACIST necessary | |||
*6fr. PA catheter | |||
*5F JL4/JR4 | |||
*Short straight stiff glidewire for valve crossing | |||
*5fr AL1 | |||
*Exchange length J wire | |||
===Radial with Eaucath=== | |||
*Eaucath | |||
*His blue angiocath | |||
*Micropuncture set | |||
*260 J-wire | |||
====Sequence==== | |||
#Access with angiocath | |||
#MP wire | |||
#MP sheath | |||
#Radial drugs | |||
#260J-wire | |||
#Eaucath | |||
===R/L Heart for AS with Langston=== | |||
*2x 5/6 slender radial sheaths with angiocath | |||
**(Santa Rosa)1 7 Fr slender radial sheath with angiocath, 1 6 Fr Prelude sheath with stiff micropuncture set | |||
*2x manifold transducers | |||
**Dr. is OK with using a manifold for the case, no ACIST necessary | |||
*6fr. PA catheter | |||
*5fr. Tig | |||
*7fr. Langston catheter | |||
*Short straight stiff glidewire | |||
*5fr AL1 | |||
*Exchange length J wire | |||
====Sequence==== | |||
#Access ultrasound guided vein | |||
#Standard Radial access | |||
#PA catheter for pressures | |||
#Tig for cors | |||
#Exchange over long wire Tig for AL1 | |||
#J out for Glidewire | |||
#Cross valve | |||
#Exchange over long wire AL1 for Langston | |||
#Use standard transducers for accuracy, do not use ACIST | |||
<br /><hr /> | |||
[[Category:Physicians]] | [[Category:Physicians]] |
Latest revision as of 18:21, 15 November 2023
Glove size | 7 *CHECK DD's PROCEDURAL PLAN IN H&P FOR SUPPLIES |
---|---|
Access |
|
Radial Setup |
|
Radial Cocktail |
|
Groin Setup |
|
Closure Device |
|
Right Heart Setup |
|
Intervention Setup | |
Phone Number | 1-415-385-9243 |
Pager Number |
Notes:
LHC for Renal Transplant
See Pre-Kidney Heart Cath
- Femoral access
- U/S probe cover
- Micropuncture
- 6frx10cm Pinnacle sheath
- 6fr. JL4 guide
- 6fr. JR4 guide
- Runthrough
- Co-Pilot
- Wire introducer
- .035x150 J
- Perclose
- ACIST setup
- Biplane
Protip: Make sure arms and armboards are tucked-in as much as possible!
Sequence
- Access with Micropuncture and U/s.
- JL4 - trade out J-wire for Runthrough.
- Isocenter
- He will use Runthrough to confirm engagement.
- 4 for 6 on the ACIST, once he fills the guide note the contrast count. This is zero.
- Biplane to RAO/Cranial and LAO/Caudal
- Take the shot
- Exchange L4 for R4
- 2 for 3 on the ACIST
- Same as Left for engagement and contrast.
- Perclose
CTO
- Preclose
- 8fr. x 45 Brite Tip sheath
- Assume bilateral groins
- ACIST and 3-port manifold
- Watchdogs
- Retrograde channel on McKesson in red.
- Left groin will have retrograde guide.
- Right groin will have antegrade guide
FFR
- Adenosine IC 10 mcg/ml concentration
Post Heart Transplant LHC/IVUS with DD
- 4/5 Glide Sheath
- 5F JR4 Diagnostic
- 5F EBU3.5
- Runthrough
- IVUS
R/L Heart for AS no Langston
- Micropuncture
- 7F 70cm Shuttle Sheath or Ansel 70cm
- 5F angled pigtail
- 6F 10cm pinnacle
- 2x manifold transducers
- Dr. is OK with using a manifold for the case, no ACIST necessary
- 6fr. PA catheter
- 5F JL4/JR4
- Short straight stiff glidewire for valve crossing
- 5fr AL1
- Exchange length J wire
Radial with Eaucath
- Eaucath
- His blue angiocath
- Micropuncture set
- 260 J-wire
Sequence
- Access with angiocath
- MP wire
- MP sheath
- Radial drugs
- 260J-wire
- Eaucath
R/L Heart for AS with Langston
- 2x 5/6 slender radial sheaths with angiocath
- (Santa Rosa)1 7 Fr slender radial sheath with angiocath, 1 6 Fr Prelude sheath with stiff micropuncture set
- 2x manifold transducers
- Dr. is OK with using a manifold for the case, no ACIST necessary
- 6fr. PA catheter
- 5fr. Tig
- 7fr. Langston catheter
- Short straight stiff glidewire
- 5fr AL1
- Exchange length J wire
Sequence
- Access ultrasound guided vein
- Standard Radial access
- PA catheter for pressures
- Tig for cors
- Exchange over long wire Tig for AL1
- J out for Glidewire
- Cross valve
- Exchange over long wire AL1 for Langston
- Use standard transducers for accuracy, do not use ACIST