Aortic Valvuloplasty: Difference between revisions

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== Mitral Valvuloplasty - DRAFT ==
__TOC__
(Toray INOUE - Balloon)


1 RFV Access. X2
{{Note| [[Valvuloplasty Balloon Chart]]}}


Conscious sedation by RN
==Daniels/Spies - (Draft)==


TTE and ICE guidance (need sonographer)
===Echo available for TTE===


Prerequisite: TEE done in Echo lab morning of to exclude LAA thrombus
===Sheaths:===


Sheaths:
====Open====
•1    Probe Cover
•1    5Fr VS Micropuncture Kit
•1    9 Fr x >20 cm sheath RFV access
•1    8 Fr Short sheath
•1    8.5 Fr SL 1 transseptal sheath


*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


Closure:
====Standby====
•1    6Fr Perclose
*8fr x 35 BriteTip (Pacing)
•1    Extra sterile mosquitos for Perclose       
*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


2 Manifold Set Up: No ACIST
===Balloon : ===
•2    3-port manifold
===* New DD preference - True Balloon* ===


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


===Emergency Standby:===


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


Wires:
*Patient prepped and draped with femoral drape
•1 cm Straight Tip Amplatz Super Stiff 260 cm
*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.
•Cordis “J” Wire 0.035 x 150 cm
*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)
Standby Items:
*Safari 2 wire inserted and catheter removed.
•
*Balloon inserted.
 
*Pacing capture tested.
 
*Balloon inflated, image stored.  
 
*Pigtail advanced for gradient measurement.  
Catheters:
*MD completes first perclose, sheath removed, 2nd perclose inserted.
•1    5Fr. Multipurpose catheter
 
 
•1    5 Fr Arrow Swan
 
 
 
Standby Items:
•
 
•
 
 
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


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


•Dilators
<br />


==Hui / Milechman - (Draft)==


•0.035 J Wire 150 cm
===Sheaths:===


====Open====


•60 ml syringe
*12fr x 30 sheath - Type?
*6fr x 10cm Pinnacle


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


•Pericardiocenteis drainage bag
*5fr angled pig
*5fr AL1 diagnostic Hui
*6fr RCB (Milechman)
*6fr Langston


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


•Bard Pigtail drainage catheter size per MD request
*Straight stiff Glidewire 150
*Cordis 150 straight wire
*Cordis 260J
*.032 x 260 wire ?


===Misc. Supplies===
====Open====


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


Emergency Plug Dislodgement/Retrieval Supplies
====Standby====
•NA


*Pacer equipment?


•IABP is device of choice for complication of severe mitral regurgitation
<br />
 
<br>
[[Category:Procedures]]
<HR />
<HR />
APPROVED: MD initials MM/YY
APPROVED: MD initials MM/YY

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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