TEER with PASCAL: Difference between revisions
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!Anethesia | |||
!Imaging | |||
!Access | |||
|- | |||
|General | |||
|Fluoro, TEE | |||
|4F Femoral Vein for drawing ACT's | |||
<nowiki>**</nowiki>If functional MR/low EF Anesthesia to obtain A line and femoral venous sheath not needed | |||
|- | |||
! colspan="3" |'''Pre-Procedure Watchouts''' | |||
|- | |||
| colspan="3" |** Tidal Volume during time-out! | |||
|} | |||
Product prep and procedural information: https://edwardsglobal.showpad.biz/s/3MckUqAe | |||
===Big Equipment:=== | ===Big Equipment:=== | ||
* | *TAVR Pack | ||
*Non-Sterile stabilizer provided by Rep | *Non-Sterile stabilizer provided by Rep | ||
*Baylis generator | *Baylis generator | ||
{{Note| When using the Philips 4D ICE probe use a 10F sheath for ACT draws. }} | === * NEW - Baylis Transseptal === | ||
* VersaCross system | |||
* Grounding pad | |||
{{Note| When using the Philips 4D ICE probe use a 10F 30 cm (from EP) sheath for ACT draws. }} | |||
===Misc supplies:=== | ===Misc supplies:=== | ||
*4fr. Pinnacle sheath for ACT (not needed if anesthesia has an A line.) | *4fr. Pinnacle sheath for ACT (not needed if anesthesia has an A line.) | ||
*Micropuncture | *Micropuncture | ||
* | *(1)Perclose (2 for Agrawal) | ||
*( | *Nu-Knit and Dermabond (If Daniels is primary) | ||
*0-prolene Suture for woggle | *0-prolene Suture for woggle (If Spies is primary) | ||
*( | *(1) 60cc syringe | ||
*Sterile towel pack for back table | *Sterile towel pack for back table | ||
*Naked 3-port manifold to measure LA pressure only | *Naked 3-port manifold to measure LA pressure only | ||
* | *Rampart drape (If Daniels) | ||
*U/S probe cover | *U/S probe cover | ||
*back table cover | *back table cover | ||
====Standby==== | ====Standby==== | ||
*20fr. DrySeal for recovering wire to LUPV | *20fr. DrySeal for recovering wire to LUPV | ||
*8x40 135cm Mustang balloon | *8x40 135cm Mustang balloon | ||
*12fr. Short Cook sheath | *12fr. Short Cook sheath (Includes 8fr. dilator for Preclose | ||
*SL1 sheath | |||
*Large curve Baylis needle | |||
*Baylis cable | |||
==Procedure== | ==Procedure== | ||
*Anesthesia will obtain radial art line prior to draping. | *Anesthesia will obtain radial art line prior to draping. | ||
| Line 41: | Line 53: | ||
*Prep patient and drape per usual. Drape anesthesia pole and/or xray shield. | *Prep patient and drape per usual. Drape anesthesia pole and/or xray shield. | ||
*GUIDE and CLIP prepped by rep. | *GUIDE and CLIP prepped by rep. | ||
*Obtain RFV access, dilate with 8F, | *Obtain RFV access, dilate with 8F, versacross pigtail wire inserted into perclose. | ||
* | *Versacross sheath advaned | ||
* | *Transeptal puncture, pigtail wire advanced | ||
* | *Versacross sheath removed, dilate over pigtail wire | ||
*Setup stabilizer. | *Setup stabilizer. | ||
*PASCAL Guide sheath inserted. Asperate 45ml of blood with a 60 cc syringes than flush with 45ml of hep saline. | *PASCAL Guide sheath inserted. Asperate 45ml of blood with a 60 cc syringes than flush with 45ml of hep saline. | ||
*Amplatz wire and dilator removed. Clip inserted. | *Amplatz wire and dilator removed. Clip inserted. | ||
Latest revision as of 23:32, 18 November 2024
| Anethesia | Imaging | Access |
|---|---|---|
| General | Fluoro, TEE | 4F Femoral Vein for drawing ACT's
**If functional MR/low EF Anesthesia to obtain A line and femoral venous sheath not needed |
| Pre-Procedure Watchouts | ||
| ** Tidal Volume during time-out! | ||
Product prep and procedural information: https://edwardsglobal.showpad.biz/s/3MckUqAe
Big Equipment:
- TAVR Pack
- Non-Sterile stabilizer provided by Rep
- Baylis generator
* NEW - Baylis Transseptal
- VersaCross system
- Grounding pad
Note: When using the Philips 4D ICE probe use a 10F 30 cm (from EP) sheath for ACT draws.
Misc supplies:
- 4fr. Pinnacle sheath for ACT (not needed if anesthesia has an A line.)
- Micropuncture
- (1)Perclose (2 for Agrawal)
- Nu-Knit and Dermabond (If Daniels is primary)
- 0-prolene Suture for woggle (If Spies is primary)
- (1) 60cc syringe
- Sterile towel pack for back table
- Naked 3-port manifold to measure LA pressure only
- Rampart drape (If Daniels)
- U/S probe cover
- back table cover
Standby
- 20fr. DrySeal for recovering wire to LUPV
- 8x40 135cm Mustang balloon
- 12fr. Short Cook sheath (Includes 8fr. dilator for Preclose
- SL1 sheath
- Large curve Baylis needle
- Baylis cable
Procedure
- Anesthesia will obtain radial art line prior to draping.
- Pre procedure TEE imaging performed
- Prior to prepping patient, place MitraClip Plate (plexiglass board – hinge side up) under patient’s leg off center to the right. Place PASCAL Lift (step stool) over patients right leg. Make sure there is direct contact between stool and plate.
- Prep patient and drape per usual. Drape anesthesia pole and/or xray shield.
- GUIDE and CLIP prepped by rep.
- Obtain RFV access, dilate with 8F, versacross pigtail wire inserted into perclose.
- Versacross sheath advaned
- Transeptal puncture, pigtail wire advanced
- Versacross sheath removed, dilate over pigtail wire
- Setup stabilizer.
- PASCAL Guide sheath inserted. Asperate 45ml of blood with a 60 cc syringes than flush with 45ml of hep saline.
- Amplatz wire and dilator removed. Clip inserted.
- Set up for subsequent clips if needed.
- Vicryl used for groin closure.
BACK TABLE SETUP
Rep's will need (2) 60 mL syringes, (1) 10 mL syringe, a large and small bowl.
All equipment prepped by reps.
