Lampoon

Please see valve in MAC for Lampoon for up to date antegrade lampoon notes.

Procedure to lacerate the Mitral valve leaflet to clear LVOT obstruction in the setting of TMVR.

This equipment list should be considered as add-on equipment to a TMVR procedure. It is not a complete procedure list!

Contrast use is unlikely for valve in valve and valve in ring variants.

• Astato 300cm
• Amplatz Super Stiff 1cm tip
• Piggyback converter catheter
• Runthrough 300
• Bovie Pen
• 2 - Touhy-Borst
• 2 - Regular stopcock
• 2 - 12” Extension
• 2 - 60cc syringe
• 2 - .014 torque device
• 18 x 30 En-Snare
• Agilis (Ask before opening)
• 6fr balloon wedge catheter
• (2) 7fr JL3.5 guide
• Langston Pigtail
• 6fr. MPA diagnostic
• 6fr. X 10cm Pinnacle
• 14fr. Dry Seal
• 12,14,16 mm x 40 balloons (Ask for size) Mustang or XXL balloons

Procedure- rough synopsis from past case notes

• LFV accessed and 8F sheath inserted
• RFA accessed and 6F sheath inserted
• RFV accessed, preclosed, and Esheath inserted.
• RHC performed
• Langston used to measure LV/AO
• SL1 advanced and transseptal needle inserted. Transseptal puncture.
• .032 exchange wire advanced. Dilator removed, MPA inserted to PV
• Wire exchanged for Amplatz SS. MPA removed.
• Septostomy performed.
• 6F balloon wedge advanced through Agilis.

***notes difficult to follow- will continue procedure steps after reviewing images. JD 3/27***

Standby

• 7fr JR4 guide