Alta Valve: Difference between revisions

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<nowiki>***</nowiki> THIS IS A RESEARCH CASE ; EQUIPMENT WILL NOT SCAN, PLEASE KEEP BARCODES OF ALL NON-SCANNABLE EQUIPMENT FOR ROSALIE WITH A PATIENT LABEL ***  
<nowiki>***</nowiki> THIS IS A RESEARCH CASE ; EQUIPMENT WILL NOT SCAN, PLEASE KEEP BARCODES OF ALL NON-SCANNABLE EQUIPMENT FOR ROSALIE WITH A PATIENT LABEL ***  


As of today 1/25/2025 we have done ONE of these procedures ( on 3/29/2024 ). This page is rough draft and will be updated along the way.  
As of today 1/21/2025 we have done TWO of these procedures (on 3/29/2024 & 1/21/25). This page is rough draft and will be updated along the way.  


'''Room Set Up ; 2 Manifolds needed for pressure, one with contrast incase of coronary angio. No Acist. Stabilizer 100cm from zyphoid notch. Rampart, yes if the deployment angles allow.'''  
'''Room Set Up ; 2 Manifolds needed for pressure, one with contrast incase of coronary angio. No Acist. Stabilizer 100cm from zyphoid notch. Rampart, yes if the deployment angles allow.'''  
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* Micropuncture  
* Micropuncture  
* 8Fr Pinnacle
* 8Fr Pinnacle
* 2 Perclose  
* 6F Pinnacle
* 24fr DrySeal  
* 3 Perclose
* 24fr DrySeal -'''ASK BEFORE OPENING'''
* 6Fr Balloon wedge PA catheter
* 6Fr Balloon wedge PA catheter
* VersaCross transeptal system
* VersaCross transeptal system
Line 18: Line 19:
* 0.035 x 260 J-tip wire
* 0.035 x 260 J-tip wire
* (2) 5fr Pigtail catheters or 1 double lumen pigtail catheter (Langston)   
* (2) 5fr Pigtail catheters or 1 double lumen pigtail catheter (Langston)   
* '''RV Pacing setup''' - There is no wire in the LV that could be used for pacing
* Alligator cables for OTW '''LV pacing'''
* Platinum Plus
* Stand support plate (example: plate used for MitraClip) placed under patient’s legs
* Stand support plate (example: plate used for MitraClip) placed under patient’s legs
* 2 transducer sets (RHC; AO/LV monitoring)
* 2 transducer sets (RHC; AO/LV monitoring)
*
*1 copilot for langston
*Presto indeflator
* '''Implant and Delivery System Preparation -Back table'''  
* '''Implant and Delivery System Preparation -Back table'''  
* (3) Sterile Bowls (1000ml or larger)  
* (3) Sterile Bowls (1000ml or larger)  
* 4L heparinized saline  
* 2L heparinized saline
* (4) Luer lock syringes (50ml or larger)  
* (4) Luer lock syringes (50ml or larger)  
* (1) Pickup  
* (1) Pickup  
* (1) Y-Tuohy Borst Sidearm Connector
* (2) Y-Tuohy Borst Sidearm Connector
* (1) 3-way Stopcock  
* (2) High pressure 3-way Stopcock
* (1) Pressure bag  
* (1) Pressure bag  
* (3) 6ft Sterile Hemostatic lines
* IV pole on wheels
* Extra sterile gowns and gloves available for 4C team  
* Extra sterile gowns and gloves available for 4C team  


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* LFA access, 6Fr pinnacle.
* LFA access, 6Fr pinnacle.
* Coronary angio?  
* Coronary angio?  
* Insert langston to get AO/LV
* Place copilot on langston and advance Platinum Plus to LV, leave there to pace during deployment if needed. Leave black clip in connected, cover with towel.
* RHC. Expect PA sat for Fick CO/CI.  
* RHC. Expect PA sat for Fick CO/CI.  
* Insert versacross curly wire to exchange 8F sheath for Versacross.
* Transeptal puncture.
* Transeptal puncture.
* Vessel dilated with dryseal dilator.
* 8F Sheath reinserted to perform septostomy
* Vessel dilated with 22F long taper dilator
* Valve delivery advanced across the septum.
* Valve delivery advanced across the septum.
* Delivery aspiration with 60 cc syringe.
* Delivery aspiration with 2 60 cc syringe.
* "waterfall" wet to wet technique for valve advancement.
* "waterfall" wet to wet technique for valve advancement.
*
*Valve deployment
*Remove delivery system, keep delivery sheath in place
*Place 22F dilator INTO delivery sheath to use for 260 J-wire advancement
*Walk sheath and dilator out over J-wire and cinch both perclose devices and use knu-knit
*Lido with Epi given
*Perclose LFA
Rep's names:
 
* Jon Berndt
* Danielle Agrifoglio
* Adam Galloway
* Sararana Kumar
* Teresa Grunklee


[[Category:Procedures]]
[[Category:Procedures]]

Latest revision as of 23:02, 22 January 2025

*** THIS IS A RESEARCH CASE ; EQUIPMENT WILL NOT SCAN, PLEASE KEEP BARCODES OF ALL NON-SCANNABLE EQUIPMENT FOR ROSALIE WITH A PATIENT LABEL ***

As of today 1/21/2025 we have done TWO of these procedures (on 3/29/2024 & 1/21/25). This page is rough draft and will be updated along the way.

Room Set Up ; 2 Manifolds needed for pressure, one with contrast incase of coronary angio. No Acist. Stabilizer 100cm from zyphoid notch. Rampart, yes if the deployment angles allow.

Supplies

  • TAVI Pack
  • Micropuncture
  • 8Fr Pinnacle
  • 6F Pinnacle
  • 3 Perclose
  • 24fr DrySeal -ASK BEFORE OPENING
  • 6Fr Balloon wedge PA catheter
  • VersaCross transeptal system
  • 10mm Mustang for septostomy or a 14mm Armada
  • Knu-Knit, Dermabond, Lido with EPI
  • 0.035 x 260 J-tip wire
  • (2) 5fr Pigtail catheters or 1 double lumen pigtail catheter (Langston)
  • Alligator cables for OTW LV pacing
  • Platinum Plus
  • Stand support plate (example: plate used for MitraClip) placed under patient’s legs
  • 2 transducer sets (RHC; AO/LV monitoring)
  • 1 copilot for langston
  • Presto indeflator
  • Implant and Delivery System Preparation -Back table
  • (3) Sterile Bowls (1000ml or larger)
  • 2L heparinized saline
  • (4) Luer lock syringes (50ml or larger)
  • (1) Pickup
  • (2) Y-Tuohy Borst Sidearm Connector
  • (2) High pressure 3-way Stopcock
  • (1) Pressure bag
  • Extra sterile gowns and gloves available for 4C team

Bail Out Equipment List

(List provided by Vendor)

  • ECMO
  • IABP
  • Impella CP
  • Blood transfusion ability
  • Pacemaker interrogator if applicable per patient (for rapid pacing)
  • Peripheral vascular balloons – over the wire, 0.035” wire compatible Septal Closure and PVL Instrument List
  • Septal Closure Devices available – 2 per size: • Gore Cardioform PFO: 20mm, 25mm, 30mm • Abbott Amplatzer Cribaform: 18mm, 25mm, 30mm, 35mm • Corresponding delivery systems to match the above devices
  • PVL plug devices available - (for example: Amplatzer ADO2 in these sizes: 4x6mm, 5x4mm, 5x6mm, 6x4mm, 6x6mm) Corresponding delivery systems to match the above devices (must be at least 80cm in length)
  • 110cm Cook Ansel or Shuttle in both 4 French and 5 French


Procedural Steps:

  • RFV access, pre-closed twice. 8Fr pinnacle advanced.
  • LFA access, 6Fr pinnacle.
  • Coronary angio?
  • Insert langston to get AO/LV
  • Place copilot on langston and advance Platinum Plus to LV, leave there to pace during deployment if needed. Leave black clip in connected, cover with towel.
  • RHC. Expect PA sat for Fick CO/CI.
  • Insert versacross curly wire to exchange 8F sheath for Versacross.
  • Transeptal puncture.
  • 8F Sheath reinserted to perform septostomy
  • Vessel dilated with 22F long taper dilator
  • Valve delivery advanced across the septum.
  • Delivery aspiration with 2 60 cc syringe.
  • "waterfall" wet to wet technique for valve advancement.
  • Valve deployment
  • Remove delivery system, keep delivery sheath in place
  • Place 22F dilator INTO delivery sheath to use for 260 J-wire advancement
  • Walk sheath and dilator out over J-wire and cinch both perclose devices and use knu-knit
  • Lido with Epi given
  • Perclose LFA

Rep's names:

  • Jon Berndt
  • Danielle Agrifoglio
  • Adam Galloway
  • Sararana Kumar
  • Teresa Grunklee
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