Perc. Transvenous Mitral Commissurotomy: Difference between revisions
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==DRAFT== | ==DRAFT== | ||
===Device:=== | ===Device:=== | ||
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*Toray INOUE-Balloon Kit | *Toray INOUE-Balloon Kit | ||
Size determined using the equation (height in cm/10 +10), but verify with MD because body habitus is also a factor. | Size determined using the equation (height in cm/10 +10), but verify with MD because body habitus is also a factor. | ||
=== Sheaths: === | ===Sheaths:=== | ||
====Open==== | ====Open==== | ||
| Line 31: | Line 29: | ||
<br /> | <br /> | ||
===Misc Supplies:=== | |||
=== Catheters: === | |||
* 7F Swan (if recent RHC has not been performed) | |||
* 8F Accunav | |||
=== Misc Supplies: === | |||
====Open==== | ====Open==== | ||
*Micropuncture | *Micropuncture | ||
US probe cover | |||
*(2) 3-port manifolds | *(2) 3-port manifolds | ||
*Closure | *Closure | ||
**0-Prolene | **0-Prolene | ||
**Perclose | **Perclose | ||
* | === Procedure: === | ||
* Dual venous access with micropuncture and ultrasound. | |||
** 8F standard sheath for Swan insertion if necessary. If no RHC, Preclose followed by SL1. | |||
** 9F 25cm sheath for ICE catheter | |||
* Swan advanced for RHC pressures (if needed) | |||
* ICE advanced | |||
* Transseptal equipment advanced and septostomy performed | |||
* LA pressure measurement | |||
* Balloon Prepped on back table | |||
** 80/20 saline to contrast concentration | |||
** Vent port cleared with contrast solution until solution flows from main inflating channel. | |||
** Balloon sizing verified by filling and measuring with enclosed calipers | |||
** Slenderizer inserted to elongate balloon | |||
** MD will shape stylet to match LA anatomy | |||
* Guidewire advanced to LA | |||
* SL1 removed. ICE catheter removed. | |||
* Black dilator advanced and removed | |||
* Balloon advanced | |||
* Verification by TTE for acceptable Mitral valve crossing | |||
* Balloon inflation performed and gradients measured by echo | |||
* Inflation repeated if necessary | |||
* Guidewire reinserted | |||
* Stylet removed, slenderizer advanced. Guidewire reinserted. | |||
* All equipment removed and perclose knot locked. | |||
* Figure 8 stitch around 9F sheath. Sheath removed. | |||
<br /> | <br /> | ||
Revision as of 01:14, 19 December 2019
DRAFT
Device:
- Toray INOUE-Balloon Kit
Size determined using the equation (height in cm/10 +10), but verify with MD because body habitus is also a factor.
Sheaths:
Open
- 9frx25cm Pinnacle
- 8frx10cm Pinnacle
- 8.5 SL1 transseptal
Wires:
Open
- Cordis 150J
TransSeptal Equipment:
Open
- Baylis generator from EP
- Large curve C1 Baylis needle
- Baylis cable
- Grounding pad
Catheters:
- 7F Swan (if recent RHC has not been performed)
- 8F Accunav
Misc Supplies:
Open
- Micropuncture
US probe cover
- (2) 3-port manifolds
- Closure
- 0-Prolene
- Perclose
Procedure:
- Dual venous access with micropuncture and ultrasound.
- 8F standard sheath for Swan insertion if necessary. If no RHC, Preclose followed by SL1.
- 9F 25cm sheath for ICE catheter
- Swan advanced for RHC pressures (if needed)
- ICE advanced
- Transseptal equipment advanced and septostomy performed
- LA pressure measurement
- Balloon Prepped on back table
- 80/20 saline to contrast concentration
- Vent port cleared with contrast solution until solution flows from main inflating channel.
- Balloon sizing verified by filling and measuring with enclosed calipers
- Slenderizer inserted to elongate balloon
- MD will shape stylet to match LA anatomy
- Guidewire advanced to LA
- SL1 removed. ICE catheter removed.
- Black dilator advanced and removed
- Balloon advanced
- Verification by TTE for acceptable Mitral valve crossing
- Balloon inflation performed and gradients measured by echo
- Inflation repeated if necessary
- Guidewire reinserted
- Stylet removed, slenderizer advanced. Guidewire reinserted.
- All equipment removed and perclose knot locked.
- Figure 8 stitch around 9F sheath. Sheath removed.
APPROVED: MD initials MM/YY
