Intrepid valve

Note: CALL MILENA AS SOON AS PATIENT IS IN THE ROOM!! 415-368-3094

File:Intrepid supply list.pdf

Intrepid table Setup

Intrepid table Setup

Intrepid table Setup

Note: TIMEOUT - Be sure that any temporary catheter across the tricuspid valve is removed prior to deployment

Setup Notes

• Reps prep - ~ 1 hour! (Make sure reps are prepping valve WAYYY before we prep the patient)
  • (6) liters cold saline
  • (2) Pressure bags with NS for device drips
  • (3) bowls with 500ml NS in each
  • (1) 60 cc with 30ml of Hep Saline the other two are for Saline.
  • Pickups for back table

• Mitra-clip plate and stool provided by reps (Stool edge is 100cm from mid-sternum)

• Use Coban to attach long table to short table end-to-end to make extra long table
• LV pacing

Open

• TAVR pack
• Back table cover
• Micropuncture
• 6fr. Pinnacle
• 8fr. Pinnacle
• Safari
• 0.035 x150 J-wire
• Lunderquist DC 260cm
• Rampart Drape
• 5Fr JR4 diagnostic catheter
• 5Fr angled pigtail
• Alligator clip pacing cable
• (3) Perclose
• 2 Roto-tubing(for back table)
• 2 60ml syringes (for back table)
• 2 20ml syringes (for back table)
• Acist setup with 100% contrast for RV or LV gram

Procedure

1. 6Fr Sheath RFA with micropuncture
2. 8Fr Sheath RFV with 18 gauge entry needle access
3. RFV Pre-closed x 2
4. 150 J loaded into perclose and 8Fr sheath in RFV
5. JR4 advanced to SVC for wire exchange.
6. J-wire removed for Lunderquist.
7. 40Fr Dilator in and out.
8. Intrepid sheath inserted over Lunderquist
9. Manipulate valve to pre-deployment position
10. 150J loaded in Pigtail -> LFA to cross Aortic valve
11. J-wire out for Safari
12. Safari positioned in LV and alligator clip attached (black to back)
13. Pacing threshold tested
14. Final positioning of valve and deployed while pacing.
15. Safari and pigtail
16. Intrepid sheath removed and perclose completed. May need a 2-0 prolene for mattress stitch.
17. Perclose to RFA