David Daniels M.D.: Difference between revisions
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{{Physician | {{Physician | ||
|Glove size=7 | |Glove size=7 *CHECK DD's PROCEDURAL PLAN IN H&P FOR SUPPLIES | ||
|Access=U/s and micropuncture | |Access=U/s and micropuncture | ||
|Radial Setup=4/5 angiocath dx only, 5/6 angiocath pci, Tig4, 260J | |Radial Setup=4/5 angiocath dx only, 5/6 angiocath pci, Tig4, 260J | ||
|Radial Cocktail=200 mcg NTG,2.5mg Verapamil, 60u/kg Heparin | |Radial Cocktail=200 mcg NTG,2.5mg Verapamil, 60u/kg Heparin | ||
|Groin Setup=6fr sheath, | |Groin Setup=6fr sheath, 6Fr JL4 / JR4 | ||
|Closure Device=Perclose | |Closure Device=Perclose | ||
|Right Heart Setup=Manifold | |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 | |Phone Number=1-415-385-9243 | ||
}} | }} | ||
| Line 12: | Line 12: | ||
===LHC for Renal Transplant=== | ===LHC for Renal Transplant=== | ||
====See [[Pre-Kidney Heart Cath]]==== | |||
*Femoral access | *Femoral access | ||
*U/S probe cover | *U/S probe cover | ||
| Line 19: | Line 20: | ||
*6fr. JR4 guide | *6fr. JR4 guide | ||
*Runthrough | *Runthrough | ||
*Co-Pilot | |||
*Wire introducer | |||
*.035x150 J | *.035x150 J | ||
*Perclose | *Perclose | ||
| Line 36: | Line 39: | ||
#Same as Left for engagement and contrast. | #Same as Left for engagement and contrast. | ||
#Perclose | #Perclose | ||
===CTO=== | ===CTO=== | ||
| Line 44: | Line 46: | ||
*ACIST and 3-port manifold | *ACIST and 3-port manifold | ||
*Watchdogs | *Watchdogs | ||
*Retrograde channel on McKesson in red. | *Retrograde channel on McKesson in red. | ||
*Left groin will have retrograde guide. | *Left groin will have retrograde guide. | ||
*Right groin will have antegrade guide | *Right groin will have antegrade guide | ||
===FFR=== | ===FFR=== | ||
*Adenosine IC 10 mcg/ml concentration | *Adenosine IC 10 mcg/ml concentration | ||
===Post Heart Transplant LHC/IVUS with DD=== | ===Post Heart Transplant LHC/IVUS with DD=== | ||
| Line 62: | Line 60: | ||
*Runthrough | *Runthrough | ||
*IVUS | *IVUS | ||
===R/L Heart for AS no Langston=== | ===R/L Heart for AS no Langston=== | ||
*Micropuncture | *Micropuncture | ||
*7F | *7F 70cm Shuttle Sheath or Ansel 70cm | ||
*5F | *5F angled pigtail | ||
*6F 10cm pinnacle | *6F 10cm pinnacle | ||
*2x manifold transducers | *2x manifold transducers | ||
| Line 76: | Line 73: | ||
*5fr AL1 | *5fr AL1 | ||
*Exchange length J wire | *Exchange length J wire | ||
===Radial with Eaucath=== | ===Radial with Eaucath=== | ||
| Line 83: | Line 79: | ||
*Micropuncture set | *Micropuncture set | ||
*260 J-wire | *260 J-wire | ||
====Sequence==== | ====Sequence==== | ||
#Access with angiocath | #Access with angiocath | ||
| Line 91: | Line 89: | ||
#Eaucath | #Eaucath | ||
===R/L Heart for AS with Langston=== | ===R/L Heart for AS with Langston=== | ||
*2x 5/6 slender radial sheaths with angiocath | *2x 5/6 slender radial sheaths with angiocath | ||
Latest revision as of 18:21, 15 November 2023
| Glove size | 7 *CHECK DD's PROCEDURAL PLAN IN H&P FOR SUPPLIES |
|---|---|
| Access |
|
| Radial Setup |
|
| Radial Cocktail |
|
| Groin Setup |
|
| Closure Device |
|
| Right Heart Setup |
|
| Intervention Setup | |
| Phone Number | 1-415-385-9243 |
| Pager Number |
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
Protip: Make sure arms and armboards are tucked-in as much as possible!
Sequence
- Access with Micropuncture and U/s.
- JL4 - trade out J-wire for Runthrough.
- Isocenter
- 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.
- Biplane to RAO/Cranial and LAO/Caudal
- Take the shot
- Exchange L4 for R4
- 2 for 3 on the ACIST
- Same as Left for engagement and contrast.
- 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
- Access with angiocath
- MP wire
- MP sheath
- Radial drugs
- 260J-wire
- 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
- 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
