David Daniels M.D.: Difference between revisions

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{{Physician
|Glove size=7 *CHECK DD's PROCEDURAL PLAN IN H&P FOR SUPPLIES
|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
|Phone Number=1-415-385-9243
}}
==Notes:==


==Physician Name==
===LHC for Renal Transplant===
 
====See [[Pre-Kidney Heart Cath]]====
{| class="wikitable"
*Femoral access
|-
*U/S probe cover
!Contact
*Micropuncture
|
*6frx10cm Pinnacle sheath
*[[Has phone number::000-000-0000]]
*6fr. JL4 guide
*[[Has pager number::000-000-0000]]
*6fr. JR4 guide
|-
*Runthrough
!Glove Size
*Co-Pilot
|
*Wire introducer
:[[Has glove size::7.5 Ortho]]
*.035x150 J
|-
*Perclose
!Micropuncture/US
*ACIST setup
|
*Biplane
*[[Has micro pref::*Micro/US for Arterial]]
{{Protip|Make sure arms and armboards are tucked-in as much as possible!}}
*[[Has micro pref::*Big needle for venous]]
====Sequence====
|-
#Access with Micropuncture and U/s.
!Radial Setup
#JL4 - trade out J-wire for Runthrough.
|
#Isocenter
:[[Has radial pref::Same as PH]]
#He will use Runthrough to confirm engagement.
|-
#4 for 6 on the ACIST, once he fills the guide note the contrast count. This is zero.
!Radial Cocktail
#Biplane to RAO/Cranial and LAO/Caudal
|
#Take the shot
*[[Has radial drug::*200 NTG]]
#Exchange L4 for R4
*[[Has radial drug::*2.5 Verapamil]]
#2 for 3 on the ACIST
*[[Has radial drug::*60u/Kg Heparin]]
#Same as Left for engagement and contrast.
|-
#Perclose
!Groin Setup
|
:[[Has groin pref::Standard]]
|-
!Interventional Setup
|
*[[Has Interventional pref::Runthrough]]
|-
!Closure Device
|
:[[Has closure pref::Perclose]]
|-
!Right Heart Setup
|
:[[Has right heart pref::Not likely]]
|-


|}
===CTO===
*Preclose
*8fr. x 45 Brite Tip sheath
*Assume bilateral groins
*ACIST and 3-port manifold
*Watchdogs


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


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


*ITEMS TO ALWAYS OPEN
===Post Heart Transplant LHC/IVUS with DD===
*(2) Items in ALL CAPS
*4/5 Glide Sheath
*(quantity) ITEM
*5F JR4 Diagnostic
*5F EBU3.5
*Runthrough
*IVUS


====Standby====
===R/L Heart for AS no Langston===
*Micropuncture
*7F 70cm Shuttle Sheath or Ansel 70cm
*5F angled pigtail
*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


*STANDBY ITEMS
===Radial with Eaucath===
*GO HERE
*Eaucath
*His blue angiocath
*Micropuncture set
*260 J-wire


====Procedure====


*Bullet list of typical procedure steps
====Sequence====
*More steps
#Access with angiocath
#MP wire
#MP sheath
#Radial drugs
#260J-wire
#Eaucath


Inset alternative steps
===R/L Heart for AS with Langston===
or notes
*2x 5/6 slender radial sheaths with angiocath
Start line with a space
**(Santa Rosa)1 7 Fr slender radial sheath with angiocath, 1 6 Fr Prelude sheath with stiff micropuncture set
      More spaces inset more
*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


<HR />
<br /><hr />
 
===Procedures separated by HR lines===
 
<HR /><HR />
 
APPROVED: MD initials MM/YY


[[Category:Physicians]]
[[Category:Physicians]]

Latest revision as of 18:21, 15 November 2023


Glove size 7 *CHECK DD's PROCEDURAL PLAN IN H&P FOR SUPPLIES
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:

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 no Langston

  • Micropuncture
  • 7F 70cm Shuttle Sheath or Ansel 70cm
  • 5F angled pigtail
  • 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

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

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

  1. Access ultrasound guided vein
  2. Standard Radial access
  3. PA catheter for pressures
  4. Tig for cors
  5. Exchange over long wire Tig for AL1
  6. J out for Glidewire
  7. Cross valve
  8. Exchange over long wire AL1 for Langston
  9. Use standard transducers for accuracy, do not use ACIST


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