MAC Lampoon steps: Difference between revisions

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#SL1 removed
#SL1 removed
#Agilis x2 advanced into LA
#Agilis x2 advanced into LA
#6fr. PA loaded with Runthrough inserted into Agilis
#6fr JR4 guide loaded with .035x150 inserted into 8fr LFA sheath
#Wire removed and Gooseneck inserted into JR4
#Runthrough snared in AO
#Runthrough externalized
#PA catheter removed
#6fr. JL3.5 advanced over Runthrough
#Second 6fr JR4 with J-wire advanced through second Agilis
#Wire removed and Lampoon system advanced
#Gooseneck snare inserted into JL3.5
#IF ballooning leaflet for “Keyhole” technique make sure to keep wire straight until after ballooning
#Leaflet traversed
#*Bovie settings: 30 cut to test and 70 cut for traversal and laceration
#Snare Astato wire
#Runthrough and Arterial guide removed
#Pacer inserted
#Balloon pump inserted
#Leaflet lacerated
#Guides and Lampoon System removed
#*Have one Agilis, SL1 and .032 wire ready to re-cross septum
#Safari loaded in Pigtail and advanged to LV
#Pigtail removed
#Septostomy
#Valve inserted and deployed
#Pigtail used to remove Safari
#If a post deployment gradient is needed, balloon pump will be removed and short 8F sheath exchanged for 8F 90cm shuttle sheath. 125cm pigtail inserted to LV. 2nd manifold needed.

Latest revision as of 21:07, 9 September 2021

  1. RRA access -> 6fr slender
    • Grandslam to check access to arch
    • Grandslam removed until access is completed
  2. LFA access -> 8fr dilator -> Pre-close -> 8fr. Pinnacle
  3. LFV access -> 8.5fr. X 23 brite tip
  4. RFV access -> 8fr dilator -> Pre-close x2 -> Amplatz Super Stiff -> 26 Dry Seal
  5. 6fr pigtail through LFA for arch shot
    • 6 FPS and subtraction
  6. Grandslam loaded in Sentinel and inserted
    • Pigtail removed after Sentinel deployed
  7. .032x260 loaded in SL1 and advanced through Dryseal
  8. Wire removed and Baylis needle advanced
  9. Transseptal puncture
  10. If septum is soft/thin:
    • SL1 advanced into LA
    • .032x260 x2 inserted into LA via SL1
  11. If septum is thick/tough:
    • .032x260 inserted into SL1 with MPA and placed in LUPV
    • .032 exchanged for Amplatz SS 1cm
    • SL1 advanced into LA
    • Amplatz SS exchanged for .032x260 x2 inserted into LA
  12. SL1 removed
  13. Agilis x2 advanced into LA
  14. 6fr. PA loaded with Runthrough inserted into Agilis
  15. 6fr JR4 guide loaded with .035x150 inserted into 8fr LFA sheath
  16. Wire removed and Gooseneck inserted into JR4
  17. Runthrough snared in AO
  18. Runthrough externalized
  19. PA catheter removed
  20. 6fr. JL3.5 advanced over Runthrough
  21. Second 6fr JR4 with J-wire advanced through second Agilis
  22. Wire removed and Lampoon system advanced
  23. Gooseneck snare inserted into JL3.5
  24. IF ballooning leaflet for “Keyhole” technique make sure to keep wire straight until after ballooning
  25. Leaflet traversed
    • Bovie settings: 30 cut to test and 70 cut for traversal and laceration
  26. Snare Astato wire
  27. Runthrough and Arterial guide removed
  28. Pacer inserted
  29. Balloon pump inserted
  30. Leaflet lacerated
  31. Guides and Lampoon System removed
    • Have one Agilis, SL1 and .032 wire ready to re-cross septum
  32. Safari loaded in Pigtail and advanged to LV
  33. Pigtail removed
  34. Septostomy
  35. Valve inserted and deployed
  36. Pigtail used to remove Safari
  37. If a post deployment gradient is needed, balloon pump will be removed and short 8F sheath exchanged for 8F 90cm shuttle sheath. 125cm pigtail inserted to LV. 2nd manifold needed.
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