TAVI-JenaValve: Difference between revisions

From Bay Area Structural Heart Wiki
(update to pacer use.)
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'''ACIST A1000V SYRINGE USED WITH 50/50 CONTRAST MIX'''
'''ACIST A1000V SYRINGE USED WITH 50/50 CONTRAST MIX'''


'''If patient has permanent pacer, no need for TVP. Pacing is only used for backup (not deployment).'''
'''As of 12/11 we will now use pacing for ALL Jenavalve implants.'''


'''Anesthesia- GA is standard.  May consider MAC based on patient.  If MAC, may want ICE.'''
'''Anesthesia- GA is standard.  May consider MAC based on patient.  If MAC, may want ICE.'''
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*8Fr x 10 cm sheath (Dilator used only)
*8Fr x 10 cm sheath (Dilator used only)
*8Fr x 35 cm Brite Tip Sheath
*8Fr x 35 cm Brite Tip Sheath
*18F Cook Sheath- on standby  
*18F Cook Sheath- on standby


===Wires:===
===Wires:===
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===PROCEDURAL INFO:===
===PROCEDURAL INFO:===


*Standard TAVR access.  NO V IF PT HAS PACEMAKER.
*Standard TAVR access.   
*Pigtail in contralateral access, injection for coplanar angle.
*Pigtail in contralateral access, injection for coplanar angle.
*Change injector to 10/10 after coplanar angle established.
*Change injector to 10/10 after coplanar angle established.
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*Jwire exchanged for Safari and pigtail removed
*Jwire exchanged for Safari and pigtail removed
*JV Guide sheath inserted (when ACT above 250)
*JV Guide sheath inserted (when ACT above 250)
*Delivery system attached to pressure bag via co-pilot on front table.
*Valve inserted and deployed
*Valve inserted and deployed
*Delivery system pulled back into JVsheath
*Delivery system pulled back into JVsheath

Revision as of 17:11, 15 December 2020


Daniels/Spies - Draft

ACIST A1000V SYRINGE USED WITH 50/50 CONTRAST MIX

As of 12/11 we will now use pacing for ALL Jenavalve implants.

Anesthesia- GA is standard. May consider MAC based on patient. If MAC, may want ICE.

Sheaths:

  • 5Fr Micropunture Kit
  • 6Fr x 10cm sheath
  • 8Fr x 10 cm sheath (Dilator used only)
  • 8Fr x 35 cm Brite Tip Sheath
  • 18F Cook Sheath- on standby

Wires:

  • (2) Cordis 150J
  • Cordis 260J
  • Safari 2

Catheters:

  • 5Fr MPA
  • 5Fr Angled Pigtail
  • 5F MBP on standby

Medications on table:

  • Lido/Bupivicaine 50/50
  • Epinephrine 10mcg/ml in red medallion syringe (From anesthesia)

Miscellaneous Supplies

  • 3-port manifold kit
  • Acist hand control
  • 3L cold saline
  • 1L warm saline
  • (2) 60ml syringes
  • (2) 20ml syringes
  • stopcock
  • co-pilot
  • 108cm tubing
  • 500ml hep saline on pressure bag
  • (3) Perclose
  • (5) bowls

Transvenous pacemaker supplies

  • 5Fr Josephson Pacing catheter
  • Dual Red/Black Pacing Remington cables
  • EP Quad Cable

PROCEDURAL INFO:

  • Standard TAVR access.
  • Pigtail in contralateral access, injection for coplanar angle.
  • Change injector to 10/10 after coplanar angle established.
  • Pigtail exchanged for MPA
  • Pigtail advanced on primary side for valve crossing over J wire
  • Jwire exchanged for Safari and pigtail removed
  • JV Guide sheath inserted (when ACT above 250)
  • Delivery system attached to pressure bag via co-pilot on front table.
  • Valve inserted and deployed
  • Delivery system pulled back into JVsheath
  • Possible exchange for 18F if concern about pulling safari through/BAV needed