BASILICA: Difference between revisions
From Bay Area Structural Heart Wiki
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*14frx33cm Gore Dry Seal Flex '''(Like seriously, ready to open!)''' | *14frx33cm Gore Dry Seal Flex '''(Like seriously, ready to open!)''' | ||
*Gooseneck snares 25, 30mm | *Gooseneck snares 25, 30mm | ||
*.035 QuickCross | *.035 QuickCross | ||
*AL2, AL3, EBU4, EBU 3.75 (Left leaflet) | *AL2, AL3, EBU4, EBU 3.75 (Left leaflet) | ||
* | *PJR4, JR4, IM, AR1 (Right leaflet) | ||
*(3) .014 torque devices | *(3) .014 torque devices | ||
*(2) .035 torque devices | *(2) .035 torque devices | ||
Revision as of 04:23, 13 February 2020
(Bioprosthetic Aortic Scallop Intentional Laceration to prevent Iatrogenic Coronary Artery obstruction)
Open
- 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
- Piggyback wire converter 4fr x 145
- 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
- 14frx33cm Gore Dry Seal Flex (Like seriously, ready to open!)
- Gooseneck snares 25, 30mm
- .035 QuickCross
- AL2, AL3, EBU4, EBU 3.75 (Left leaflet)
- PJR4, JR4, IM, AR1 (Right leaflet)
- (3) .014 torque devices
- (2) .035 torque devices
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
