Intrepid valve: Difference between revisions
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[[File:Intrepid_supply_list.pdf|thumb|page=1|right|Supply list from Medtronic]] | {{Note|CALL MILENA AS SOON AS PATIENT IS IN THE ROOM!! 415-368-3094}}</BR>[[File:Intrepid_supply_list.pdf|thumb|page=1|right|Supply list from Medtronic]] | ||
[[File:IntrepidTable1.jpg|thumb|150px|right|Intrepid table Setup]] | |||
[[File:IntrepidTable2.jpg|thumb|150px|right|Intrepid table Setup]] | |||
[[File:IntrepidTable3.jpg|thumb|150px|right|Intrepid table Setup]] | |||
__NOINDEX__ | __NOINDEX__ | ||
===Setup Notes=== | ===Setup Notes=== | ||
| Line 5: | Line 8: | ||
**6 liters cold saline | **6 liters cold saline | ||
**Pressure bags x2 for device drips | **Pressure bags x2 for device drips | ||
**Open | **Open 1 extra pickups (suture removal kit) | ||
**Mitra-clip plate and stool | **Mitra-clip plate and stool provided by reps | ||
*Use Coban to attach long table to short table end-to-end to make extra long table(drape first). | *Use Coban to attach long table to short table end-to-end to make extra long table(drape first). | ||
*Surgical access | *Surgical access | ||
| Line 15: | Line 18: | ||
*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 26: | Line 28: | ||
*0.035x150 J-wire | *0.035x150 J-wire | ||
*5fr. JR4 diagnostic catheter | *5fr. JR4 diagnostic catheter | ||
* | *Lunderquist J-wire 260cm | ||
*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 19:36, 19 January 2024
Note: CALL MILENA AS SOON AS PATIENT IS IN THE ROOM!! 415-368-3094
File:Intrepid supply list.pdf
Setup Notes
- Reps prep - ~ 1 hour!
- 6 liters cold saline
- Pressure bags x2 for device drips
- Open 1 extra pickups (suture removal kit)
- Mitra-clip plate and stool provided by reps
- 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
- Lunderquist J-wire 260cm
- 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
