David Daniels M.D.: Difference between revisions

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{{Physician
{{Cardiologist
|Glove size=7
|Glove size=7  
|Access=U/s and micropuncture
|Access=U/s and micropuncture
|Radial Setup=4/5 angiocath dx only, 5/6 angiocath pci, Tig4, 260J
|Radial Setup=4/5 angiocath dx only, 5/6 angiocath pci, Tig4, 260J
|Radial Cocktail=200 mcg NTG,2.5mg Verapamil, 60u/kg Heparin
|Radial Cocktail=200 mcg NTG,2.5mg Verapamil, 60u/kg Heparin
|Groin Setup=6fr sheath,  '''5FR.''' JL4 / JR4
|Groin Setup=6fr sheath,  6Fr JL4 / JR4
|Closure Device=Perclose
|Closure Device=Perclose
|Right Heart Setup=Manifold, Brachial with US, 6fr wedge cath, 5/6 slender angiocath, .035 wire, micropuncture
|Right Heart Setup=Manifold, 6fr wedge cath, 5/6 slender angiocath, .035 wire, RN to put brachial IV in, Biopsy - Jaws ALWAYS
|Phone Number=1-415-385-9243
|Phone Number=1-415-385-9243
}}
}}
==Notes:==
==Notes:==
{{Protip|CHECK DD's PROCEDURAL PLAN IN H&P FOR SUPPLIES}}


===LHC for Renal Transplant===
===LHC for Renal Transplant===
====See [[Pre-Kidney Heart Cath]]====
*Femoral access
*Femoral access
*U/S probe cover
*U/S probe cover
Line 19: Line 22:
*6fr. JR4 guide
*6fr. JR4 guide
*Runthrough
*Runthrough
*Co-Pilot
*Wire introducer
*.035x150 J
*.035x150 J
*Perclose
*Perclose
Line 24: Line 29:
*Biplane
*Biplane
{{Protip|Make sure arms and armboards are tucked-in as much as possible!}}
{{Protip|Make sure arms and armboards are tucked-in as much as possible!}}
====Sequence===
====Sequence====
#Access with Micropuncture and U/s.
#Access with Micropuncture and U/s.
#JL4 - trade out J-wire for Runthrough.
#JL4 - trade out J-wire for Runthrough.
Line 36: Line 41:
#Same as Left for engagement and contrast.
#Same as Left for engagement and contrast.
#Perclose
#Perclose


===CTO===
===CTO===
Line 44: Line 48:
*ACIST and 3-port manifold
*ACIST and 3-port manifold
*Watchdogs
*Watchdogs
<br />


*Retrograde channel on McKesson in red.
*Retrograde channel on McKesson in red.
*Left groin will have retrograde guide.
*Left groin will have retrograde guide.
*Right groin will have antegrade guide
*Right groin will have antegrade guide


===FFR===
===FFR===
*Adenosine IC 10 mcg/ml concentration
*Adenosine IC 10 mcg/ml concentration


===Post Heart Transplant LHC/IVUS with DD===
===Post Heart Transplant LHC/IVUS with DD===
Line 63: Line 63:
*IVUS
*IVUS


===R/L Heart for AS ===
*85cm R2P Sheath
*4F pigtail
*(2) 6F Radial sheath
* 6Fr Balloon Wedge


===R/L Heart for AS no Langston===
* (2) manifold transducers (for simultaneous pressures)
*Micropuncture
*5F TIG for coronary angiography
*7F 90cm Shuttle Sheath
*Short straight stiff glide wire for valve crossing
*5F 125cm pigtail
*5fr AL1 for valve crossing
*6F 10cm pinnacle 
*2x manifold transducers
**Dr. is OK with using a manifold for the case, no ACIST necessary
*6fr. PA catheter
*5F JL4/JR4
*Short straight stiff glidewire for valve crossing
*5fr AL1
*Exchange length J wire
*Exchange length J wire


 
====Sequence====
#Access ultrasound guided vein access if no existing IV
#Standard Radial access
#PA catheter for pressures
#Tig for cors
#Exchange over long wire Tig for R2P sheath
#AL1 and straight stiff glide for valve crossing
#Exchange AL1 for 4fr Pig
===Radial with Eaucath===
===Radial with Eaucath===
*Eaucath
*Eaucath
Line 90: Line 96:
#260J-wire
#260J-wire
#Eaucath
#Eaucath
<br />
===R/L Heart for AS with Langston===
*2x 5/6 slender radial sheaths with angiocath
**(Santa Rosa)1 7 Fr slender radial sheath with angiocath, 1 6 Fr Prelude sheath with stiff micropuncture set
*2x manifold transducers
**Dr. is OK with using a manifold for the case, no ACIST necessary
*6fr. PA catheter
*5fr. Tig
*7fr. Langston catheter
*Short straight stiff glidewire
*5fr AL1
*Exchange length J wire
====Sequence====
#Access ultrasound guided vein
#Standard Radial access
#PA catheter for pressures
#Tig for cors
#Exchange over long wire Tig for AL1
#J out for Glidewire
#Cross valve
#Exchange over long wire AL1 for Langston
#Use standard transducers for accuracy, do not use ACIST
<br /><hr />
[[Category:Physicians]]

Latest revision as of 20:08, 31 December 2025


Glove size 7
Access
  • U/s and micropuncture
Radial Setup
  • 4/5 angiocath dx only
  • 5/6 angiocath pci
  • Tig4
  • 260J
Radial Cocktail
  • 200 mcg NTG
  • 2.5mg Verapamil
  • 60u/kg Heparin
Groin Setup
  • 6fr sheath
  • 6Fr JL4 / JR4
Closure Device
  • Perclose
Right Heart Setup
  • Manifold
  • 6fr wedge cath
  • 5/6 slender angiocath
  • .035 wire
  • RN to put brachial IV in
  • Biopsy - Jaws ALWAYS
Intervention Setup
Phone Number 1-415-385-9243
Pager Number

Edit this page

Notes:

Note Protip: CHECK DD's PROCEDURAL PLAN IN H&P FOR SUPPLIES

LHC for Renal Transplant

See Pre-Kidney Heart Cath

  • Femoral access
  • U/S probe cover
  • Micropuncture
  • 6frx10cm Pinnacle sheath
  • 6fr. JL4 guide
  • 6fr. JR4 guide
  • Runthrough
  • Co-Pilot
  • Wire introducer
  • .035x150 J
  • Perclose
  • ACIST setup
  • Biplane

Note Protip: Make sure arms and armboards are tucked-in as much as possible!

Sequence

  1. Access with Micropuncture and U/s.
  2. JL4 - trade out J-wire for Runthrough.
  3. Isocenter
  4. He will use Runthrough to confirm engagement.
  5. 4 for 6 on the ACIST, once he fills the guide note the contrast count. This is zero.
  6. Biplane to RAO/Cranial and LAO/Caudal
  7. Take the shot
  8. Exchange L4 for R4
  9. 2 for 3 on the ACIST
  10. Same as Left for engagement and contrast.
  11. Perclose

CTO

  • Preclose
  • 8fr. x 45 Brite Tip sheath
  • Assume bilateral groins
  • ACIST and 3-port manifold
  • Watchdogs
  • Retrograde channel on McKesson in red.
  • Left groin will have retrograde guide.
  • Right groin will have antegrade guide

FFR

  • Adenosine IC 10 mcg/ml concentration

Post Heart Transplant LHC/IVUS with DD

  • 4/5 Glide Sheath
  • 5F JR4 Diagnostic
  • 5F EBU3.5
  • Runthrough
  • IVUS

R/L Heart for AS

  • 85cm R2P Sheath
  • 4F pigtail
  • (2) 6F Radial sheath
  • 6Fr Balloon Wedge
  • (2) manifold transducers (for simultaneous pressures)
  • 5F TIG for coronary angiography
  • Short straight stiff glide wire for valve crossing
  • 5fr AL1 for valve crossing
  • Exchange length J wire

Sequence

  1. Access ultrasound guided vein access if no existing IV
  2. Standard Radial access
  3. PA catheter for pressures
  4. Tig for cors
  5. Exchange over long wire Tig for R2P sheath
  6. AL1 and straight stiff glide for valve crossing
  7. Exchange AL1 for 4fr Pig

Radial with Eaucath

  • Eaucath
  • His blue angiocath
  • Micropuncture set
  • 260 J-wire

Sequence

  1. Access with angiocath
  2. MP wire
  3. MP sheath
  4. Radial drugs
  5. 260J-wire
  6. Eaucath
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