Tricuspid Evoque: Difference between revisions
From Bay Area Structural Heart Wiki
No edit summary |
|||
| (One intermediate revision by the same user not shown) | |||
| Line 9: | Line 9: | ||
!<big>Stablizer</big> | !<big>Stablizer</big> | ||
! | ! | ||
!<big>85 cm from | !<big>85 cm from Xiphoid</big> | ||
|- | |- | ||
|General | |General | ||
| Line 49: | Line 49: | ||
* Blunt tip forceps & Scissors | * Blunt tip forceps & Scissors | ||
==Standby Items== | ==To Get by Standby Items== | ||
* Verasight ICE probe (TAVR closet) | * Verasight ICE probe (TAVR closet) | ||
| Line 58: | Line 58: | ||
# Pre procedure TEE imaging performed | # Pre procedure TEE imaging performed | ||
# Prior to prepping patient, place white plastic board under patient’s leg off center to the right. Place Lift (step stool) over patients right leg. Measure 85cm from | # Prior to prepping patient, place white plastic board under patient’s leg off center to the right. Place Lift (step stool) over patients right leg. Measure 85cm from xiphoid. Make sure there is direct contact between stool and plate. | ||
# Prep patient and drape per usual. Drape rampart and/or xray shield. | # Prep patient and drape per usual. Drape rampart and/or xray shield. | ||
# Obtain FV access, dilate with 8F, preclose. .032 wire inserted into perclose. | # Obtain FV access, dilate with 8F, preclose. .032 wire inserted into perclose. | ||
Latest revision as of 17:27, 27 December 2024
| Anesthesia | Imaging | Access |
|---|---|---|
| Stablizer | 85 cm from Xiphoid | |
| General | Fluoro,
Tee |
RFV
A-Line started by anesthesia on all patients |
Note: Supplies do not scan, keep stickers in book!
Timeout Watch Out - IS THERE A DEVICE ACROSS THE TRICUSPID VALVE?
Sheaths
- Micro puncture
- 8F Sheath for dilator only
- 4F Pinnacle (not needed if anesthesia has A-line.)
Wires
- .032 x 260 "J" wire
- Safarii
Misc. Supplies
- (2) Perclose
- 8.5F Agilis
- Alligator cables for pacing - Used for emergency backup pacing
- Suture removal kit (for back table)
- Nu-knit
- Exofin topical adhesive
BACK TABLE SETUP
- Table cover
- 11 Blade
- 4 Bowls
- Normal room temp saline 3.5L
- Heparinized Saline .5L
- Blunt tip forceps & Scissors
To Get by Standby Items
- Verasight ICE probe (TAVR closet)
- 10Fr 30cm sheath ( structural cart)
- 6Fr Balloon wedge for RHC
Steps
- Pre procedure TEE imaging performed
- Prior to prepping patient, place white plastic board under patient’s leg off center to the right. Place Lift (step stool) over patients right leg. Measure 85cm from xiphoid. Make sure there is direct contact between stool and plate.
- Prep patient and drape per usual. Drape rampart and/or xray shield.
- Obtain FV access, dilate with 8F, preclose. .032 wire inserted into perclose.
- Agilis advanced.
- .032 replaced with safari wire.
- Safari and agilis advanced across the TV under TEE and fluoro guidance.
- Agilis removed and 33Fr dilator in and out.
- 28Fr delivery with valve advanced.
- Once the anchors leave delivery they cannot be retracted. Device has to be deployed or the patient needs to go to the OR for surgical removal.
- Once device is deployed delivery is removed and access site is perclosed. Exofin and go home.
