TEER with PASCAL: Difference between revisions

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| colspan="3" |** Tidal Volume during time-out!
| colspan="3" |** Tidal Volume during time-out!
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Product prep and procedural information: https://edwardsglobal.showpad.biz/s/3MckUqAe


===Big Equipment:===
===Big Equipment:===
*Cath pack
*TAVR Pack
*Clear Plexiglass base support
*Non-Sterile stabilizer provided by Rep
*Non-Sterile stabilizer provided by Rep
*Baylis generator
*Baylis generator
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* VersaCross system  
* VersaCross system  
 
* Grounding pad  
=== Bellow items on standby!
*SL1 TransSeptal sheath
*Large curve Baylis needle
*Baylis cable
* Grounding pad ===
{{Note| When using the Philips 4D ICE probe use a 10F 30 cm (from EP) sheath for ACT draws. }}
{{Note| When using the Philips 4D ICE probe use a 10F 30 cm (from EP) sheath for ACT draws. }}
===Wires:===
*.032 X 260 “J” wire
*Amplatz SuperStiff 1cm Tip 260cm
===Catheters:===
*5F MPA2
===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
*8F Sheath for dilator only
*(1)Perclose (2 for Agrawal)
*(1)Perclose (If Spies is primary, NO perclose if Daniles is primary.)
*Nu-Knit and Dermabond (If Daniels is primary)  
*0-prolene  Suture for woggle
*0-prolene  Suture for woggle (If Spies is primary)
*(2) 60cc syringe
*(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
*Fluoro cover to anesthesia IV pole or moving xray shield
*Rampart drape (If Daniels)
*U/S probe cover
*U/S probe cover
*back table cover
*back table cover
*Large and small bowl for back table
====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.
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*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, preclose. .032 wire inserted into perclose.
*Obtain RFV access, dilate with 8F, versacross pigtail wire inserted into perclose.
*SL1 introduced over .032 wire.
*Versacross sheath advaned
*Baylis needle inserted and echo imaging performed. Transseptal puncture performed.
*Transeptal puncture, pigtail wire advanced
*Baylis needle removed. .032wire inserted. Dilator removed
*Versacross sheath removed, dilate over pigtail wire
*MPA advanced over the wire to pulmonary vein. LA pressure measured. Give MD Amplatz SuperStiff to shape.
*Amplatz superStiff advanced.
*MPA removed.
*Setup stabilizer.
*Setup stabilizer.
*SL1 removed.
*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 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.