MAC Lampoon steps

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