Tricuspid Evoque

Anesthesia	Imaging	Access
Stablizer		85 cm from zyphoid
General	Fluoro, Tee	Typical primary access on RFV -A-line, OR 4F in LFA for ACT's

Warning: Research case, they will bring valve supplies

Note: Supplies do not scan, keep stickers in book!

Sheaths

• Micro puncture
• 8F Sheath for dilator only
• 4F Pinnacle (not needed if anesthesia has A-line.)

Wires

• .032 x 260 "J" wire
• Safarii

Misc. Supplies

• (2) Perclose
• 8.5F Agilis
• Alligator cables for pacing
• Suture removal kit (for back table)
• Nu-knit
• Exofin topical adhesive

BACK TABLE SETUP

• Table cover
• 11 Blade
• 4 Bowls
• Normal room temp saline 3.5L
• Heparinized Saline .5L
• Blunt tip forceps & Scissors

Standby Items

• Verasight ICE prob (TAVR closet)
• 10Fr 30cm sheath ( EP Laser Cart)
• 6Fr Balloon wedge for RHC

Steps

1. Pre procedure TEE imaging performed
2. Prior to prepping patient, place white plastic board under patient’s leg off center to the right. Place Lift (step stool) over patients right leg. Measure 85cm from xyphoid. Make sure there is direct contact between stool and plate.
3. Prep patient and drape per usual. Drape rampart and/or xray shield.
4. Obtain FV access, dilate with 8F, preclose. .032 wire inserted into perclose.
5. Agilis advanced.
6. .032 replaced with safari wire.
7. Safari and agilis advanced across the TV under TEE and fluoro guidance.
8. Agilis removed and 33Fr dilator in and out.
9. 28Fr delivery with valve advanced.
10. Once the anchors leave delivery they cannot be retracted. Device has to be deployed or the patient needs to go to the OR for surgical removal.
11. Once device is deployed delivery is removed and access site is perclosed. Exofin and go home.