TEER with PASCAL: Difference between revisions
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Created page with " ===Big Equipment:=== *Cath pack *Clear Plexiglass base support *Non-Sterile stabilizer provided by Rep *Baylis generator ===Baylis Transseptal:=== *SL1 TransSeptal sheath *La..." |
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{| class="wikitable" | |||
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!Anethesia | |||
!Imaging | |||
!Access | |||
|- | |||
|General | |||
|Fluoro, TEE | |||
|4F Femoral Vein for drawing ACT's | |||
<nowiki>**</nowiki>If functional MR/low EF Anesthesia to obtain A line and femoral venous sheath not needed | |||
|- | |||
! colspan="3" |'''Pre-Procedure Watchouts''' | |||
|- | |||
| colspan="3" |** Tidal Volume during time-out! | |||
<nowiki>****</nowiki> 76 inches from subxiphoid | |||
|} | |||
Product prep and procedural information: https://edwardsglobal.showpad.biz/s/3MckUqAe | |||
===Big Equipment:=== | ===Big Equipment:=== | ||
* | *TAVR Pack | ||
*Non-Sterile stabilizer provided by Rep | *Non-Sterile stabilizer provided by Rep | ||
*Baylis generator | *Baylis generator | ||
===Baylis Transseptal | |||
=== * NEW - Baylis Transseptal === | |||
* | * VersaCross system | ||
*Grounding pad | * Grounding pad | ||
{{Note| When using the Philips 4D ICE probe use a 10F 30 cm (structural cart) sheath for ACT draws. }} | |||
===Misc supplies:=== | ===Misc supplies:=== | ||
*4fr. Pinnacle sheath for ACT (not needed if anesthesia has an A line.) | *4fr. Pinnacle sheath for ACT (not needed if anesthesia has an A line.) | ||
*Micropuncture | *Micropuncture | ||
* | *(1)Perclose (2 for Agrawal) | ||
*( | *Nu-Knit and Dermabond (If Daniels is primary) | ||
*0-prolene Suture for woggle | *0-prolene Suture for woggle (If Spies is primary) | ||
*( | *(1) 60cc syringe | ||
*Sterile towel pack for back table | *Sterile towel pack for back table | ||
*Naked 3-port manifold to measure LA pressure only | *Naked 3-port manifold to measure LA pressure only | ||
* | *Rampart drape (If Daniels) | ||
*U/S probe cover | *U/S probe cover | ||
*back table cover | *back table cover | ||
====Standby==== | ====Standby==== | ||
*20fr. DrySeal for recovering wire to LUPV | *20fr. DrySeal for recovering wire to LUPV | ||
*8x40 135cm Mustang balloon | *8x40 135cm Mustang balloon | ||
*12fr. Short Cook sheath | *12fr. Short Cook sheath (Includes 8fr. dilator for Preclose | ||
*SL1 sheath | |||
*Large curve Baylis needle | |||
*Baylis cable | |||
==Procedure== | ==Procedure== | ||
*Anesthesia will obtain radial art line prior to draping. | *Anesthesia will obtain radial art line prior to draping. | ||
*Pre procedure TEE imaging performed | *Pre procedure TEE imaging performed | ||
*Prior to prepping patient, place MitraClip Plate (plexiglass board – hinge side up) under patient’s leg off center to the right. Place PASCAL Lift (step stool) over patients right leg. Make sure there is direct contact between stool and plate. | *Prior to prepping patient, place MitraClip Plate (plexiglass board – hinge side up) under patient’s leg off center to the right. Place PASCAL Lift (step stool) over patients right leg. Make sure there is direct contact between stool and plate. Distance is 76 inches from subxiphoid. | ||
*Prep patient and drape per usual. Drape anesthesia pole and/or xray shield. | *Prep patient and drape per usual. Drape anesthesia pole and/or xray shield. | ||
*Obtain RFV access, dilate with 8F, | *GUIDE and CLIP prepped by rep. | ||
* | *Obtain RFV access, dilate with 8F, versacross pigtail wire inserted into perclose. | ||
* | *Versacross sheath advaned | ||
* | *Transeptal puncture, pigtail wire advanced | ||
*Versacross sheath removed, dilate over pigtail wire | |||
*Setup stabilizer. | *Setup stabilizer. | ||
*PASCAL Guide sheath inserted. Asperate 45ml of blood with a 60 cc syringes than flush with 45ml of hep saline. | *PASCAL Guide sheath inserted. Asperate 45ml of blood with a 60 cc syringes than flush with 45ml of hep saline. | ||
*Amplatz wire and dilator removed. Clip inserted. | *Amplatz wire and dilator removed. Clip inserted. | ||
| Line 57: | Line 67: | ||
All equipment prepped by reps. | All equipment prepped by reps. | ||
[[Category:Procedures]] | |||
Latest revision as of 17:23, 27 December 2024
| Anethesia | Imaging | Access |
|---|---|---|
| General | Fluoro, TEE | 4F Femoral Vein for drawing ACT's
**If functional MR/low EF Anesthesia to obtain A line and femoral venous sheath not needed |
| Pre-Procedure Watchouts | ||
| ** Tidal Volume during time-out!
**** 76 inches from subxiphoid | ||
Product prep and procedural information: https://edwardsglobal.showpad.biz/s/3MckUqAe
Big Equipment:
- TAVR Pack
- Non-Sterile stabilizer provided by Rep
- Baylis generator
* NEW - Baylis Transseptal
- VersaCross system
- Grounding pad
Note: When using the Philips 4D ICE probe use a 10F 30 cm (structural cart) sheath for ACT draws.
Misc supplies:
- 4fr. Pinnacle sheath for ACT (not needed if anesthesia has an A line.)
- Micropuncture
- (1)Perclose (2 for Agrawal)
- Nu-Knit and Dermabond (If Daniels is primary)
- 0-prolene Suture for woggle (If Spies is primary)
- (1) 60cc syringe
- Sterile towel pack for back table
- Naked 3-port manifold to measure LA pressure only
- Rampart drape (If Daniels)
- U/S probe cover
- back table cover
Standby
- 20fr. DrySeal for recovering wire to LUPV
- 8x40 135cm Mustang balloon
- 12fr. Short Cook sheath (Includes 8fr. dilator for Preclose
- SL1 sheath
- Large curve Baylis needle
- Baylis cable
Procedure
- Anesthesia will obtain radial art line prior to draping.
- Pre procedure TEE imaging performed
- Prior to prepping patient, place MitraClip Plate (plexiglass board – hinge side up) under patient’s leg off center to the right. Place PASCAL Lift (step stool) over patients right leg. Make sure there is direct contact between stool and plate. Distance is 76 inches from subxiphoid.
- Prep patient and drape per usual. Drape anesthesia pole and/or xray shield.
- GUIDE and CLIP prepped by rep.
- Obtain RFV access, dilate with 8F, versacross pigtail wire inserted into perclose.
- Versacross sheath advaned
- Transeptal puncture, pigtail wire advanced
- Versacross sheath removed, dilate over pigtail wire
- Setup stabilizer.
- PASCAL Guide sheath inserted. Asperate 45ml of blood with a 60 cc syringes than flush with 45ml of hep saline.
- Amplatz wire and dilator removed. Clip inserted.
- Set up for subsequent clips if needed.
- Vicryl used for groin closure.
BACK TABLE SETUP
Rep's will need (2) 60 mL syringes, (1) 10 mL syringe, a large and small bowl.
All equipment prepped by reps.
