Aortic Valvuloplasty: Difference between revisions

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====Open====
====Open====


*12fr x 33 DrySeal '''Ask before opening'''
*Sheath- dependent upon balloon size.  Verify with MD.
*8fr x 10 Pinnacle
*8fr x 10 Pinnacle


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===Device:===
===Device:===


====Standby====
 
[[Z-med Balloon|Z-Med Balloon]] (Ask for sizing)
[[Z-med Balloon|Z-Med Balloon]] or Tyshak Nucleus (Ask for sizing)


===Wires:===
===Wires:===
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====Open====
====Open====


*Cordis 150J
*Cordis 260J
*Cordis 260J
*Straight stiff 150 Glidewire
*Straight stiff 150 Glidewire
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*Cordis 150 straight
*Cordis 150 straight


<br />
=== Catheters: ===
 
===Catheters:===


====Open====
====Open====
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*6fr Langston
*6fr Langston


<br />
===Misc Supplies:===
===Misc Supplies:===


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*(2) 3-port manifolds
*(2) 3-port manifolds
*25g lido needle (Daniels)
*Alligator clip pacing cable
*Alligator clip pacing cable
*Orange pacing suture
*60cc syringe
*60cc syringe
*High pressure stopcock
*High pressure stopcock
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*Patient prepped and draped with femoral drape
*Patient prepped and draped with femoral drape
*Double manifold setup
*Double manifold setup
**DUAL MANIFOLDS, ACIST only if angio to be performed
**DUAL MANIFOLDS. One with contrast if coronaries to be performed.
*Access with micropuncture and ultrasound
*Access with micropuncture and ultrasound
*8F dilator to predilate tract
*8F dilator to predilate tract
*Preclose with Perclose
*Preclose with Perclose
*12F Dryseal sheath inserted
*Sheath inserted
*AL1 catheter inserted OTW and wire exchanged for straight stiff glide
*AL1 catheter inserted OTW and wire exchanged for straight stiff glide
*After crossing the valve, 260J inserted and AL1 removed, Langston inserted and simultaneous pressures measured
*After crossing the valve, 260J inserted and AL1 removed, Langston inserted and simultaneous pressures measured
*Safari 2 wire inserted and Langston removed
*Safari 2 wire inserted and Langston removed
*Pacing suture placed under the skin and distal end of Safari 2 wire shaved off with a scalpel.  Alligator pacing cable connected to wire and suture.  Thresholds tested.
*Needle placed under the skin and coating on distal end of Safari 2 wire shaved off with a scalpel.  Alligator pacing cable connected to wire and suture.  Thresholds tested.
*ZMed/Tyshak Nucleus balloon inserted and PREPPED INSIDE THE BODY.
*ZMed/Tyshak Nucleus balloon inserted and PREPPED INSIDE THE BODY.
*Rapid A Pacing performed as directed by MD.  
*Rapid A Pacing performed as directed by MD.  
*Balloon inflated, image stored.  
*Balloon inflated, image stored.  
*Langston catheter reinserted post intervention and simultaneous pressures obtained
*Langston catheter reinserted post BAV and simultaneous pressures obtained
*MD completes first perclose, sheath removed, 2nd perclose inserted.
*MD completes first perclose, sheath removed, 2nd perclose inserted.


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*[[Z-med Balloon|Z-Med valvuloplasty balloon]] - Ask for size
*[[Z-med Balloon|Z-Med valvuloplasty balloon]] - Ask for size
*High pressure stopcock
*High pressure stopcock
*Acist and manifold
*2 manifolds


====Standby====
====Standby====

Revision as of 17:05, 27 March 2020

Z-Med Inflation Chart
Other Balloons Inflation Chart


Daniels/Spies - (Draft)

Sheaths:

Open

  • Sheath- dependent upon balloon size. Verify with MD.
  • 8fr x 10 Pinnacle

Standby

  • 8fr x 35 BriteTip (Pacing)

Device:

Z-Med Balloon or Tyshak Nucleus (Ask for sizing)

Wires:

Open

  • Cordis 260J
  • Straight stiff 150 Glidewire
  • Safari 2 wire

Standby

  • Angled Glidewire
  • Amplatz super stiff 260 with 1cm tip
  • Cordis 150 straight

Catheters:

Open

  • 5fr AL1
  • 6fr Langston

Misc Supplies:

Open

  • (2) 3-port manifolds
  • Alligator clip pacing cable
  • 60cc syringe
  • High pressure stopcock
  • Atrion indeflator
  • (2) Perclose
  • Epi in red syringe

Standby

  • 5fr JSN quad catheter (TAVR pacing catheter)
  • Remington pacing cable (Tavr)
  • EP quad cable


Pericardiocentesis (Standby):

Not DD or CS

Call Echo

  • Micropuncture
  • 75 Amplatz SS
  • Pericardiocentesis tray
  • Accordion drain bag

Spies

Call Echo

Supplies:

  • Micro puncture
  • 150cm J wire
  • 4/5fr slender sheath
  • 5fr straight pigtail diagnostic
  • gravity drainage bag
  • brown reservoir lab canister
  • Two 50 or 60ml syringes


Daniels

Call Echo

Supplies

Open

Emergency Kit located in each lab containing the following items:

  • Eye drape
  • Skater introducer set
  • Bard locking pigtail (6f or 8f)
  • (3) 60ml luer lock syringe
  • Amplatz super stiff .035 180cm wire
  • Probe cover
  • Stopcock
  • Accordion drainage bag

Standby

  • Chiba biopsy needle 10cm 18g
  • Standard .035 150cm j wire

Emergency Standby:

ECMO / ECMO cart


Procedure:

  • Zoll pads placed
  • Patient prepped and draped with femoral drape
  • Double manifold setup
    • DUAL MANIFOLDS. One with contrast if coronaries to be performed.
  • Access with micropuncture and ultrasound
  • 8F dilator to predilate tract
  • Preclose with Perclose
  • Sheath inserted
  • AL1 catheter inserted OTW and wire exchanged for straight stiff glide
  • After crossing the valve, 260J inserted and AL1 removed, Langston inserted and simultaneous pressures measured
  • Safari 2 wire inserted and Langston removed
  • Needle placed under the skin and coating on distal end of Safari 2 wire shaved off with a scalpel.  Alligator pacing cable connected to wire and suture. Thresholds tested.
  • ZMed/Tyshak Nucleus balloon inserted and PREPPED INSIDE THE BODY.
  • Rapid A Pacing performed as directed by MD.  
  • Balloon inflated, image stored.  
  • Langston catheter reinserted post BAV and simultaneous pressures obtained
  • MD completes first perclose, sheath removed, 2nd perclose inserted.

APPROVED: MD initials MM/YY


Hui / Milechman - (Draft)

Sheaths:

Open

  • 12fr x 30 sheath - Type?
  • 6fr x 10cm Pinnacle

Catheters:

Open

  • 5fr angled pig
  • 5fr AL1 diagnostic Hui
  • 6fr RCB (Milechman)
  • 6fr Langston

Wires

Open

  • Straight stiff Glidewire 150
  • Cordis 150 straight wire
  • Cordis 260J
  • .032 x 260 wire ?

Misc. Supplies

Open

Standby

  • Pacer equipment?



APPROVED: MD initials MM/YY