Intrepid valve: Difference between revisions
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[[File:Intrepid_supply_list.pdf|thumb|page=1|right|Supply list from Medtronic]] {{Note| | {{Note|CALL MILENA AS SOON AS PATIENT IS IN THE ROOM!! 415-368-3094}}</BR> | ||
<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]] | |||
{{Note|TIMEOUT - Be sure that any temporary catheter across the tricuspid valve is removed prior to deployment }} | |||
__NOINDEX__ | __NOINDEX__ | ||
===Setup Notes=== | ===Setup Notes=== | ||
*Reps prep - ~ 1 hour! | *Reps prep - ~ 1 hour! (Make sure reps are prepping valve WAYYY before we prep the patient) | ||
**6 liters cold saline | **(6) liters cold saline | ||
**Pressure bags | **(2) Pressure bags with NS for device drips | ||
** | **(3) bowls with 500ml NS in each | ||
**Mitra-clip plate and stool | **(1) 60 cc with 30ml of Hep Saline the other two are for Saline. | ||
*Use Coban to attach long table to short table end-to-end to make extra long table | **Pickups for back table | ||
*Mitra-clip plate and stool provided by reps (Stool edge is 100cm from mid-sternum) | |||
* | |||
*Use Coban to attach long table to short table end-to-end to make extra long table | |||
*LV pacing | |||
===Open=== | ===Open=== | ||
*TAVR pack | *TAVR pack | ||
*Back table cover | *Back table cover | ||
*Micropuncture | |||
*6fr. Pinnacle | *6fr. Pinnacle | ||
*8fr. Pinnacle | *8fr. Pinnacle | ||
* | *Safari | ||
*0. | *0.035 x150 J-wire | ||
* | *Lunderquist DC 260cm | ||
* | *Rampart Drape | ||
*Alligator clip pacing cable ( | *5Fr JR4 diagnostic catheter | ||
* | *5Fr angled pigtail | ||
*Alligator clip pacing cable | |||
* (3) 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=== | ||
# | #6Fr Sheath RFA with micropuncture | ||
#18 gauge entry needle access - | #8Fr Sheath RFV with 18 gauge entry needle access | ||
#150 J loaded in JR4 | # RFV Pre-closed x 2 | ||
#J-wire removed for Lunderquist | #150 J loaded into perclose and 8Fr sheath in RFV | ||
#JR4 advanced to SVC for wire exchange. | |||
#J-wire removed for Lunderquist. | |||
#40Fr Dilator in and out. | |||
#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 | #150J loaded in Pigtail -> LFA to cross Aortic valve | ||
#J-wire out for Safari | #J-wire out for Safari | ||
#Safari positioned in LV and alligator clip attached (black to back) | #Safari positioned in LV and alligator clip attached (black to back) | ||
#Pacing threshold tested | #Pacing threshold tested | ||
#Final positioning of valve and deployed while pacing. | #Final positioning of valve and deployed while pacing. | ||
#Safari and | #Safari and pigtail | ||
#Intrepid sheath removed and | #Intrepid sheath removed and perclose completed. May need a 2-0 prolene for mattress stitch. | ||
#Perclose to | #Perclose to RFA | ||
[[Category:Procedures]] | [[Category:Procedures]] | ||
Latest revision as of 21:51, 24 September 2024
Note: CALL MILENA AS SOON AS PATIENT IS IN THE ROOM!! 415-368-3094
Note: TIMEOUT - Be sure that any temporary catheter across the tricuspid valve is removed prior to deployment
Setup Notes
- Reps prep - ~ 1 hour! (Make sure reps are prepping valve WAYYY before we prep the patient)
- (6) liters cold saline
- (2) Pressure bags with NS for device drips
- (3) bowls with 500ml NS in each
- (1) 60 cc with 30ml of Hep Saline the other two are for Saline.
- Pickups for back table
- Mitra-clip plate and stool provided by reps (Stool edge is 100cm from mid-sternum)
- Use Coban to attach long table to short table end-to-end to make extra long table
- LV pacing
Open
- TAVR pack
- Back table cover
- Micropuncture
- 6fr. Pinnacle
- 8fr. Pinnacle
- Safari
- 0.035 x150 J-wire
- Lunderquist DC 260cm
- Rampart Drape
- 5Fr JR4 diagnostic catheter
- 5Fr angled pigtail
- Alligator clip pacing cable
- (3) 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
- 6Fr Sheath RFA with micropuncture
- 8Fr Sheath RFV with 18 gauge entry needle access
- RFV Pre-closed x 2
- 150 J loaded into perclose and 8Fr sheath in RFV
- JR4 advanced to SVC for wire exchange.
- J-wire removed for Lunderquist.
- 40Fr Dilator in and out.
- Intrepid sheath inserted over Lunderquist
- Manipulate valve to pre-deployment position
- 150J loaded in Pigtail -> 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 pigtail
- Intrepid sheath removed and perclose completed. May need a 2-0 prolene for mattress stitch.
- Perclose to RFA
