BASILICA: Difference between revisions
From Bay Area Structural Heart Wiki
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*(2) Stopcocks | *(2) Stopcocks | ||
*4 hemostats | *4 hemostats | ||
*(2) 60ml syringes | |||
*(2) 12 inch extension tubing | |||
*Bowl of D5 | |||
===Standby=== | ===Standby=== | ||
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<br /> | <br /> | ||
=== Procedure === | ===Procedure=== | ||
* Setup and access is the same as TAVR '''''except''''' a 14F Dryseal sheath is inserted initially instead of the ESheath. | *Setup and access is the same as TAVR '''''except''''' a 14F Dryseal sheath is inserted initially instead of the ESheath. | ||
** Bovie set at 30 CUT ONLY. | **Bovie set at 30 CUT ONLY. | ||
* AL1 advanced over J wire through 6F sheath. Wire exchanged for straight stiff glidewire for valve crossing. | *AL1 advanced over J wire through 6F sheath. Wire exchanged for straight stiff glidewire for valve crossing. | ||
* AL1 exchanged over the wire for MP1 Guide with watchdog and stopcock attached. | *AL1 exchanged over the wire for MP1 Guide with watchdog and stopcock attached. | ||
* Platinum Plus wire is preshaped by MD and inserted through MP to retain LV access. | *Platinum Plus wire is preshaped by MD and inserted through MP to retain LV access. | ||
* Snare advanced through MP alongside Platinum Plus. | *Snare advanced through MP alongside Platinum Plus. | ||
* BASILICA catheter advanced through Dryseal sheath with watchdog and stopcock attached. | *BASILICA catheter advanced through Dryseal sheath with watchdog and stopcock attached. | ||
* Kinked Astato wire advanced through BASILICA catheter. | *Kinked Astato wire advanced through BASILICA catheter. | ||
* Hand injection performed to verify position of BASILICA catheter. | *Hand injection performed to verify position of BASILICA catheter. | ||
* Astato wire connected to bovie with 2 hemostats. | *Astato wire connected to bovie with 2 hemostats. | ||
* RF applied as Astato wire advanced. | *RF applied as Astato wire advanced. | ||
* Once wire penetrates leaflet it is snared and pulled into MP1. | *Once wire penetrates leaflet it is snared and pulled into MP1. | ||
* Platinum Plus wire removed | *Platinum Plus wire removed | ||
* Pacing wire advanced and tested | *Pacing wire advanced and tested | ||
* Al1 advanced next to BASILICA catheter and valve recrossed in standard fashion. | *Al1 advanced next to BASILICA catheter and valve recrossed in standard fashion. | ||
* | *60ml D5 filled syringes and extension tubing attached to sideports of guides and injected simultaneously during leaflet laceration. | ||
* MP removed. BASILICA catheter removed. | *MP removed. BASILICA catheter removed. | ||
* Amplatz ES advanced through AL1 and AL1 removed. | *Amplatz ES advanced through AL1 and AL1 removed. | ||
* Pigtail advanced to coronary cusp | *Pigtail advanced to coronary cusp | ||
* Dryseal exchanged for ESheath | *Dryseal exchanged for ESheath | ||
* Do a TAVR. | *Do a TAVR. | ||
Revision as of 00:14, 26 October 2019
(Bioprosthetic Aortic Scallop Intentional Laceration to prevent Iatrogenic Coronary Artery obstruction)
Open
- 14frx33cm Gore Dry Seal Flex
- 6fr MP1 guide catheter
- .018 Platinum Plus guidewire 260 cm
- Gooseneck Snare 20mm
- 6 Fr PAL 1.0 (for LCA BASILICA) -OR- 6 FR MPA1 Guide (For RCA BASILICA)
- .014 Astato xs 20 guidewire 300 cm
- Bovie pen
- Grounding Pad
- Bovie machine
- (2) Watchdog devices
- (2) Stopcocks
- 4 hemostats
- (2) 60ml syringes
- (2) 12 inch extension tubing
- Bowl of D5
Standby
- Gooseneck snares 25, 30mm
- Piggyback wire converter 4fr x 145 (On standby)
- .035 QuickCross (On standby)
- AL2, AL3, EBU4, EBU 3.75 (Left leaflet)
- PAR1, JR4, IM, AR1 (Right leaflet)
- (3) .014 torque devices
- (2) .035 torque devices
- Finecross 135
Procedure
- Setup and access is the same as TAVR except a 14F Dryseal sheath is inserted initially instead of the ESheath.
- Bovie set at 30 CUT ONLY.
- AL1 advanced over J wire through 6F sheath. Wire exchanged for straight stiff glidewire for valve crossing.
- AL1 exchanged over the wire for MP1 Guide with watchdog and stopcock attached.
- Platinum Plus wire is preshaped by MD and inserted through MP to retain LV access.
- Snare advanced through MP alongside Platinum Plus.
- BASILICA catheter advanced through Dryseal sheath with watchdog and stopcock attached.
- Kinked Astato wire advanced through BASILICA catheter.
- Hand injection performed to verify position of BASILICA catheter.
- Astato wire connected to bovie with 2 hemostats.
- RF applied as Astato wire advanced.
- Once wire penetrates leaflet it is snared and pulled into MP1.
- Platinum Plus wire removed
- Pacing wire advanced and tested
- Al1 advanced next to BASILICA catheter and valve recrossed in standard fashion.
- 60ml D5 filled syringes and extension tubing attached to sideports of guides and injected simultaneously during leaflet laceration.
- MP removed. BASILICA catheter removed.
- Amplatz ES advanced through AL1 and AL1 removed.
- Pigtail advanced to coronary cusp
- Dryseal exchanged for ESheath
- Do a TAVR.
Approved: MM/YY
