Aortic Valvuloplasty

Daniels/Spies - (Draft)

Sheaths:

Open

• 12fr x 33 DrySeal
• 8fr x 10 Pinnacle

Standby

• 8fr x 35 BriteTip (Pacing)

Wires:

Open

• Cordis 150J
• Cordis 260J
• Straight stiff 150 Glidewire
• Safari 2 wire

Standby

• Angled Glidewire
• Amplatz super stiff 260 with 1cm tip
• Cordis 150 straight

Catheters:

Open

• 5fr AL1
• 6fr Langston

Misc Supplies:

Open

• (2) 3-port manifolds
• 25g lido needle (Daniels)
• Alligator clip pacing cable
• Orange pacing suture
• 60cc syringe
• High pressure stopcock
• Atrion indeflator
• (2) Perclose
• Epi in red syringe

Standby

• 5fr JSN quad catheter (TAVR pacing catheter)
• Remington pacing cable (Tavr)
• EP quad cable

Not DD or CS

Call Echo

• Micropuncture
• 75 Amplatz SS
• Pericardiocentesis tray
• Accordion drain bag

Spies

Call Echo

Supplies:

• Micro puncture
• 150cm J wire
• 4/5fr slender sheath
• 5fr straight pigtail diagnostic
• gravity drainage bag
• brown reservoir lab canister
• Two 50 or 60ml syringes

Daniels

Call Echo

Supplies

Open

Emergency Kit located in each lab containing the following items:

• Eye drape
• Skater introducer set
• Bard locking pigtail (6f or 8f)
• (3) 60ml luer lock syringe
• Amplatz super stiff .035 180cm wire
• Probe cover
• Stopcock
• Accordion drainage bag

Standby

• Chiba biopsy needle 10cm 18g
• Standard .035 150cm j wire
  

Procedure:

• Zoll pads placed
• Patient prepped and draped with femoral drape
• Double manifold setup
  • DUAL MANIFOLDS, ACIST only if angio to be performed
• Access with micropuncture and ultrasound
• 8F dilator to predilate tract
• Preclose with Perclose
• 12F Dryseal sheath inserted
• AL1 catheter inserted OTW and wire exchanged for straight stiff glide
• After crossing the valve, 260J inserted and AL1 removed, Langston inserted and simultaneous pressures measured
• Safari 2 wire inserted and Langston removed
• Pacing suture placed under the skin and distal end of Safari 2 wire shaved off with a scalpel.  Alligator pacing cable connected to wire and suture. Thresholds tested.
• ZMed/Tyshak Nucleus balloon inserted and PREPPED INSIDE THE BODY.
• Rapid A Pacing performed as directed by MD.  
• Balloon inflated, image stored.  
• Langston catheter reinserted post intervention and simultaneous pressures obtained
• MD completes first perclose, sheath removed, 2nd perclose inserted.

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APPROVED: MD initials MM/YY

Hui / Milechman - (Draft)

Sheaths:

Open

• 12fr x 30 sheath - Type?
• 6fr x 10cm Pinnacle

Catheters:

Open

• 5fr angled pig
• 5fr AL1 diagnostic Hui
• 6fr RCB (Milechman)
• 6fr Langston

Wires

Open

• Straight stiff Glidewire 150
• Cordis 150 straight wire
• Cordis 260J
• .032 x 260 wire ?

Misc. Supplies

Open

• Micropuncture
• Probe cover
• (2) 60cc syringe
• Z-Med valvuloplasty balloon - Ask for size
• High pressure stopcock
• Acist and manifold

Standby

• Pacer equipment?

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APPROVED: MD initials MM/YY