PDA Closure

Spies/Daniels

• BIPLANE - Patients arms securely positioned above head , keeping brachial plexus injury in mind.
• Acist setup 100% contrast and naked-manifold for RH pressures

Sheaths:

• Micropuncture
• (2) 6F Pinnacles
• 6F 180 deg TorqueView OR 7F 180 deg TorqueView (ASK MD.) ** Last case they needed a 7F 180 but we didn’t have it and they made the 7F 90 work.

Wires:

• .035 x 260 J Wire
• 260 angled glide

Catheters:

• 6F pigtail
• 6F JR4 diagnostic
• 6F JR4 guide
• 6F MP2 guide
• 6F PA catheter
• 5F IM diagnostic

Misc. Supplies:

• 30mm Snare
• Ultrasound probe cover
• (2) 3-way stop cock
• (2) Co-Pilots
• Acist setup
• Naked manifold
• Perclose

Procedure Steps

• 6F venous and arterial access on same side.
• PA catheter advanced (If RHC needed performed now)
• Pigtail to LV for EDP and pullback
• Pigtail to arch for DSA 15/30 acist settings. (Change settings from CARD Alte. to DSA body 4, to accomplish bi-place cine)
• Pigtail removed over Glidewire
• 5F IM advanced over glide on arterial side
• PA catheter removed over the 260 J wire
• JR4 Guide catheter advanced over 260 J to the PA
• Snare advanced thru the JR4 Guide and advanced to the PDA
• Glidewire snared and pulled from the AO thru the PDA to the venous side, externalized
• JR4 and snare removed
• 5F IM exchanged for the 6F MP2 Guide
• DSA 10/10 on acist thru the MP
• MP and 6F sheath removed, TorqueView sheath advanced across the PDA to the venous side
• Glidewire removed and plug advanced
• DSA performed to confirm fit and position