Aortic Valvuloplasty: Difference between revisions

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Mitral Valvuloplasty  
{{Note| [[Valvuloplasty Balloon Chart]]}}


(Toray INOUE - Balloon)
==Daniels/Spies - (Draft)==


1 RFV Access. X2
===Echo available for TTE===


Conscious sedation by RN
===Sheaths:===


TTE and ICE guidance (need sonographer)
====Open====


Prerequisite: TEE done in Echo lab morning of to exclude LAA thrombus
*Micropuncture kit
*8fr x 10 Pinnacle
*Fast Cath sheath (one French size larger then balloon)
*Amplatz super stiff 7cm x 75 or 150 for sheath advancement
*Cordis 150J
*Straight stiff 150 Glidewire
*Safari 2 wire
*5fr AL1
*5F Pigtail
*(2) 3-port manifolds
*Alligator clip pacing cable
*60cc syringe
*High pressure stopcock
*Atrion indeflator (found in TAVI closet)
*(2) Perclose
*Suture for sheath
*Epi in red syringe
*Aligator pacing cable
*Booker pacing pad
*Nu-knit and glue


Sheaths:
====Standby====
•1    Probe Cover
*8fr x 35 BriteTip (Pacing)
•1    5Fr VS Micropuncture Kit
*Angled Glidewire
•1    9 Fr x >20 cm sheath RFV access
*Amplatz super stiff 260 with 1cm tip
•1    8 Fr Short sheath
*Cordis 150 straight
•1    8.5 Fr SL 1 transseptal sheath


*5fr JSN quad catheter (TAVR pacing catheter)
*Remington pacing cable (Tavr)
*EP quad cable


Closure:
===Balloon : ===
•1    6Fr Perclose
===* New DD preference - True Balloon* ===
•1    Extra sterile mosquitos for Perclose       


===Pericardiocentesis (Standby):===
{{Pericardiocentesis}}<br />


2 Manifold Set Up: No ACIST
===Emergency Standby:===
•2    3-port manifold


====ECMO / ECMO cart====
===Procedure:===


*Patient prepped and draped with femoral drape
*Def pad placed as grounding pad on Apex for uni-polar pacing.
*Double manifold setup
**DUAL MANIFOLDS. One with contrast if coronaries to be performed.
*Access with micro puncture and ultrasound
*8F dilator and pre-close
*12F Sheath inserted over SS wire
*AL1 catheter inserted OTW and wire exchanged for straight stiff glide
*After crossing the valve, AL1 or Pigtail used to measure simultaneous pressures. ( AO pressure hooked up to DrySeal)
*Safari 2 wire inserted and catheter removed.
*Balloon inserted.
*Pacing capture tested.
*Balloon inflated, image stored.  
*Pigtail advanced for gradient measurement.
*MD completes first perclose, sheath removed, 2nd perclose inserted.


[[Category:Procedures]]
<HR />
APPROVED: MD initials MM/YY


Wires:
<br />
•1 cm Straight Tip Amplatz Super Stiff 260 cm


==Hui / Milechman - (Draft)==


•Cordis “J” Wire 0.035 x 150 cm
===Sheaths:===


====Open====


*12fr x 30 sheath - Type?
*6fr x 10cm Pinnacle


===Catheters:===
====Open====


Standby Items:
*5fr angled pig
•
*5fr AL1 diagnostic Hui
*6fr RCB (Milechman)
*6fr Langston


===Wires===
====Open====


*Straight stiff Glidewire 150
*Cordis 150 straight wire
*Cordis 260J
*.032 x 260 wire ?


Catheters:
===Misc. Supplies===
•1    5Fr. Multipurpose catheter
====Open====


*Micropuncture
*Probe cover
*(2) 60cc syringe
*[[Z-med Balloon|Z-Med valvuloplasty balloon]] - Ask for size
*High pressure stopcock
*2 manifolds


•1    5 Fr Arrow Swan
====Standby====


*Pacer equipment?


 
<br />
Standby Items:
<HR />
•
APPROVED: MD initials MM/YY
 
•
 
 
Transeptal Access Supplies
•Large Curve C1 71cm Baylis Trans-septal Needle
 
 
•Baylis Cable
 
 
•Baylis Machine
 
 
•Orange Grounding Pad
 
 
 
 
Device Table
•1    Toray INOUE-Balloon Kit (usually 28 mm, but need 26 and 30 mm available)   
 
 
•2    1L  bag Heparinized Saline (Both on pressured bag hanging on IV pole)
 
 
•1    Large Sterile Bowl filled with 1L Heparinized Saline for device use only
 
 
•2    60 ml luer-lock syringe
 
 
•5    High-Pressure stopcock
 
 
•50 ml Visipaque contrast for balloon prep. RATIO 1:5
 
 
 
 
Emergency Pericardiocentesis Supplies
•Pericardiocentesis Tray
 
 
•Pericardiocentesis Supplies:
 
 
•5Fr VS Micropuncture
 
 
•Dilators
 
 
•0.035 J Wire 150 cm
 
 
•60 ml syringe
 
 
•Pericardiocenteis drainage bag
 
 
•Bard Pigtail drainage catheter size per MD request
 
 
 
Emergency Plug Dislodgement/Retrieval Supplies
•NA
 
 
•IABP is device of choice for complication of severe mitral regurgitation

Latest revision as of 13:34, 22 June 2024

Note Note: Valvuloplasty Balloon Chart

Daniels/Spies - (Draft)

Echo available for TTE

Sheaths:

Open

  • Micropuncture kit
  • 8fr x 10 Pinnacle
  • Fast Cath sheath (one French size larger then balloon)
  • Amplatz super stiff 7cm x 75 or 150 for sheath advancement
  • Cordis 150J
  • Straight stiff 150 Glidewire
  • Safari 2 wire
  • 5fr AL1
  • 5F Pigtail
  • (2) 3-port manifolds
  • Alligator clip pacing cable
  • 60cc syringe
  • High pressure stopcock
  • Atrion indeflator (found in TAVI closet)
  • (2) Perclose
  • Suture for sheath
  • Epi in red syringe
  • Aligator pacing cable
  • Booker pacing pad
  • Nu-knit and glue

Standby

  • 8fr x 35 BriteTip (Pacing)
  • Angled Glidewire
  • Amplatz super stiff 260 with 1cm tip
  • Cordis 150 straight
  • 5fr JSN quad catheter (TAVR pacing catheter)
  • Remington pacing cable (Tavr)
  • EP quad cable

Balloon :

* New DD preference - True Balloon*

Pericardiocentesis (Standby):

Not DD or CS

Call Echo

  • Micropuncture
  • 75 Amplatz SS
  • Pericardiocentesis tray
  • Accordion drain bag

Spies

Call Echo

Supplies:

  • Micro puncture
  • 150cm J wire
  • 4/5fr slender sheath
  • 5fr straight pigtail diagnostic
  • gravity drainage bag
  • brown reservoir lab canister
  • Two 50 or 60ml syringes


Daniels

Call Echo

Supplies

Open

Emergency Kit located in each lab containing the following items:

  • Eye drape
  • Skater introducer set
  • Bard locking pigtail (6f or 8f)
  • (3) 60ml luer lock syringe
  • Amplatz super stiff .035 180cm wire
  • Probe cover
  • Stopcock
  • Accordion drainage bag

Standby

  • Chiba biopsy needle 10cm 18g
  • Standard .035 150cm j wire

Emergency Standby:

ECMO / ECMO cart

Procedure:

  • Patient prepped and draped with femoral drape
  • Def pad placed as grounding pad on Apex for uni-polar pacing.
  • Double manifold setup
    • DUAL MANIFOLDS. One with contrast if coronaries to be performed.
  • Access with micro puncture and ultrasound
  • 8F dilator and pre-close
  • 12F Sheath inserted over SS wire
  • AL1 catheter inserted OTW and wire exchanged for straight stiff glide
  • After crossing the valve, AL1 or Pigtail used to measure simultaneous pressures. ( AO pressure hooked up to DrySeal)
  • Safari 2 wire inserted and catheter removed.
  • Balloon inserted.
  • Pacing capture tested.
  • Balloon inflated, image stored.  
  • Pigtail advanced for gradient measurement.
  • MD completes first perclose, sheath removed, 2nd perclose inserted.

APPROVED: MD initials MM/YY


Hui / Milechman - (Draft)

Sheaths:

Open

  • 12fr x 30 sheath - Type?
  • 6fr x 10cm Pinnacle

Catheters:

Open

  • 5fr angled pig
  • 5fr AL1 diagnostic Hui
  • 6fr RCB (Milechman)
  • 6fr Langston

Wires

Open

  • Straight stiff Glidewire 150
  • Cordis 150 straight wire
  • Cordis 260J
  • .032 x 260 wire ?

Misc. Supplies

Open

Standby

  • Pacer equipment?


APPROVED: MD initials MM/YY

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