BATMAN: Difference between revisions
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== BATMAN and UNICORN == | |||
* 18Fr Dryseal for non-inline Evolute (Confirm before opening) | |||
* Amplatz Extra Stiff for Sheath advancement | |||
* Suture for dryseal securement | |||
* Micropuncture | |||
* 8F sheath | |||
* (2) .035 x 150 J wires | |||
* .035 x 260 J wire | |||
* Terumo Stiff Straight Glidewire 0.035 x 150 cm | |||
* (2) Safari Wire | |||
* (3) Perclose | |||
* 7Fr MP1 Guide | |||
* 5Fr AL1 diagnostic | |||
* (2) 5Fr Ang Pigtail | |||
* .014 Astato xs 20 guidewire 300cm | |||
* FineCross 135cm | |||
* Bovie pen | |||
** Grounding Pad | |||
** Bovie machine | |||
* (2) Watchdog devices | |||
* (2) Stopcocks | |||
* (2) Needle drivers | |||
* Alligator pacing wire | |||
* Navicross | |||
=== Standby - PULLED and HANGING on WALL === | |||
* Tip deflecting wire | |||
* Sentinel | |||
=== '''Additional Standby Items - don't need to have pulled''' === | |||
* MPA1, JR4, IM, AR1 (Right leaflet) | |||
=== Procedure === | |||
* Setup and access is the same as TAVR '''''except''''' a 18F Dryseal sheath is inserted initially. | |||
** Bovie set at 30 CUT ONLY. | |||
* AL1 advanced over J wire through 7F sheath. Wire exchanged for straight stiff glidewire for valve crossing. | |||
* AL1 exchanged over the wire for MP1 Guide with watchdog and stopcock attached. | |||
* Platinum Plus wire is preshaped by MD and inserted through MP to retain LV access. | |||
* Snare advanced through MP alongside Platinum Plus. | |||
* BASILICA catheter advanced through Dryseal sheath with watchdog and stopcock attached. | |||
* Kinked Astato wire advanced through BASILICA catheter. | |||
* Hand injection performed to verify position of BASILICA catheter. | |||
* Astato wire connected to bovie with 2 hemostats. | |||
* RF applied as Astato wire advanced. | |||
* Once wire penetrates leaflet it is snared and pulled into MP1. | |||
* Platinum Plus wire removed | |||
* AL1 advanced next to BASILICA catheter and valve recrossed in standard fashion. | |||
* 60ml D5 filled syringes and extension tubing attached to sideports of guides and injected simultaneously during leaflet laceration. | |||
* MP removed. BASILICA catheter removed. | |||
* Amplatz ES advanced through AL1 and AL1 removed. | |||
* Pigtail advanced to coronary cusp | |||
* Dryseal exchanged for ESheath | |||
* Do a TAVR. | |||
[[Category:Procedures]] | [[Category:Procedures]] | ||
Latest revision as of 21:10, 7 January 2026
BATMAN and UNICORN
- 18Fr Dryseal for non-inline Evolute (Confirm before opening)
- Amplatz Extra Stiff for Sheath advancement
- Suture for dryseal securement
- Micropuncture
- 8F sheath
- (2) .035 x 150 J wires
- .035 x 260 J wire
- Terumo Stiff Straight Glidewire 0.035 x 150 cm
- (2) Safari Wire
- (3) Perclose
- 7Fr MP1 Guide
- 5Fr AL1 diagnostic
- (2) 5Fr Ang Pigtail
- .014 Astato xs 20 guidewire 300cm
- FineCross 135cm
- Bovie pen
- Grounding Pad
- Bovie machine
- (2) Watchdog devices
- (2) Stopcocks
- (2) Needle drivers
- Alligator pacing wire
- Navicross
Standby - PULLED and HANGING on WALL
- Tip deflecting wire
- Sentinel
Additional Standby Items - don't need to have pulled
- MPA1, JR4, IM, AR1 (Right leaflet)
Procedure
- Setup and access is the same as TAVR except a 18F Dryseal sheath is inserted initially.
- Bovie set at 30 CUT ONLY.
- AL1 advanced over J wire through 7F sheath. Wire exchanged for straight stiff glidewire for valve crossing.
- AL1 exchanged over the wire for MP1 Guide with watchdog and stopcock attached.
- Platinum Plus wire is preshaped by MD and inserted through MP to retain LV access.
- Snare advanced through MP alongside Platinum Plus.
- BASILICA catheter advanced through Dryseal sheath with watchdog and stopcock attached.
- Kinked Astato wire advanced through BASILICA catheter.
- Hand injection performed to verify position of BASILICA catheter.
- Astato wire connected to bovie with 2 hemostats.
- RF applied as Astato wire advanced.
- Once wire penetrates leaflet it is snared and pulled into MP1.
- Platinum Plus wire removed
- AL1 advanced next to BASILICA catheter and valve recrossed in standard fashion.
- 60ml D5 filled syringes and extension tubing attached to sideports of guides and injected simultaneously during leaflet laceration.
- MP removed. BASILICA catheter removed.
- Amplatz ES advanced through AL1 and AL1 removed.
- Pigtail advanced to coronary cusp
- Dryseal exchanged for ESheath
- Do a TAVR.
