Mitral Clip: Difference between revisions
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*(5) High Pressure Stopcock | *(5) High Pressure Stopcock | ||
*8F Sheath for dilator - (also used as a backup sheath) | *8F Sheath for dilator - (also used as a backup sheath) | ||
*Perclose | *Perclose | ||
*0 Prolene suture on a CT-1 needle (Spies) | *0 Prolene suture on a CT-1 needle (Spies) | ||
*60cc syringe | *60cc syringe | ||
*12” extension (Keep stickers to label flush tubing) | *12” extension (Keep stickers to label flush tubing) | ||
*( | *(2) Sterile towel packs for back table | ||
*3 port manifold to measure LA pressure only | *3 port manifold to measure LA pressure only | ||
*Fluoro cover to anesthesia IV pole or moving xray shield | *Fluoro cover to anesthesia IV pole or moving xray shield | ||
Line 76: | Line 76: | ||
*Micropuncture | *Micropuncture | ||
*U/S probe cover | *U/S probe cover | ||
*dump bag | |||
====Standby==== | ====Standby==== | ||
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==Procedure== | ==Procedure== | ||
* Anesthesia will obtain radial art line prior to draping. | |||
* Pre procedure TEE imaging performed | |||
Prep patient and drape per usual. | * Prior to prepping patient, place MitraClip Plate (plexiglass board – hinge side up) under patient’s leg off center to the right. Place MitralClip Lift (step stool) over patients right leg, angled down towards the head. Measure 80cm from mid-sternum to leading edge of stool. Make sure there is direct contact between stool and plate. | ||
* Prep patient and drape per usual. Drape anesthesia pole and or xray shield. | |||
* Obtain RFV access, dilate with 8F, Preclose. Hand MD .032wire loaded into micropuncture after perclose deployment. | |||
* SL1 introduced over .032 wire. | |||
* Baylis needle inserted and echo imaging performed. Septostomy performed. | |||
* Baylis needle removed. .032wire inserted. Wire and dilator removed. | |||
* MPA and Jwire inserted to pulmonary vein. Give MD Amplatz SS to shape. | |||
* Jwire removed and Amplatz SS advanced. | |||
* MPA removed. | |||
* SL1 removed | |||
* 20F dilator inserted and removed | |||
* MitraClip Guide inserted. | |||
* Setup stabilizer and silicone sheet. Hand MD 60ml syringe with short extension tubing for aspiration. | |||
* Amplatz wire and dilator removed. Clip inserted. | |||
* Drips should be maintained at 1drip every 4seconds. If bubbles are seen on echo, turn drips down. | |||
* When clip is being deployed turn room lights up and drips up. | |||
* | |||
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Start line with a space | Start line with a space | ||
More spaces inset more | More spaces inset more | ||
[[Category:Procedures]] | |||
APPROVED: MD initials MM/YY | APPROVED: MD initials MM/YY |
Revision as of 19:39, 23 October 2019
DRAFT
Mitral Clip | |||||
---|---|---|---|---|---|
Anesthesia | Imaging | Access | Pre-Procedure | ||
General | Fluoro, TEE, and ICE |
Femoral Vein |
Big Equipment:
Open
- Cath pack
- Lift / Footstool / Support base
- Clear Plexiglass base support
- Sterile System Stabilizer
- Baylis generator (Mitral only)
- ICE 8fr. and SwiftLink cover (Tricuspid only)
- 9fr x 23cm Pinnacle for ICE
Baylis/transseptal:
Not used for Tricuspid clipping
Open
- SL1 TransSeptal sheath
- Large curve Baylis needle
- Baylis cable
- Grounding pad
Standby
- BRK1 transseptal needle (Rarely used)
Wires:
Open
- Cordis 260J
- Cordis 150J
- Amplatz SuperStiff 1cm Tip
Standby
- .032 X 260 “J” wire
- .014 X 190 BMW wire
Catheters:
Open
- 5F MPA2
Misc supplies:
Open
- (2) 108cm High pressure IV Lines
- (5) High Pressure Stopcock
- 8F Sheath for dilator - (also used as a backup sheath)
- Perclose
- 0 Prolene suture on a CT-1 needle (Spies)
- 60cc syringe
- 12” extension (Keep stickers to label flush tubing)
- (2) Sterile towel packs for back table
- 3 port manifold to measure LA pressure only
- Fluoro cover to anesthesia IV pole or moving xray shield
- 20F Dilator
- Needle driver
- Micropuncture
- U/S probe cover
- dump bag
Standby
- Additional Perclose
- Pericardiocentesis supplies
Non-Sterile Supplies
- (4) Liter bags of heparinized saline
- (4) Liter sized pressure bags
Procedure
- Anesthesia will obtain radial art line prior to draping.
- Pre procedure TEE imaging performed
- Prior to prepping patient, place MitraClip Plate (plexiglass board – hinge side up) under patient’s leg off center to the right. Place MitralClip Lift (step stool) over patients right leg, angled down towards the head. Measure 80cm from mid-sternum to leading edge of stool. Make sure there is direct contact between stool and plate.
- Prep patient and drape per usual. Drape anesthesia pole and or xray shield.
- Obtain RFV access, dilate with 8F, Preclose. Hand MD .032wire loaded into micropuncture after perclose deployment.
- SL1 introduced over .032 wire.
- Baylis needle inserted and echo imaging performed. Septostomy performed.
- Baylis needle removed. .032wire inserted. Wire and dilator removed.
- MPA and Jwire inserted to pulmonary vein. Give MD Amplatz SS to shape.
- Jwire removed and Amplatz SS advanced.
- MPA removed.
- SL1 removed
- 20F dilator inserted and removed
- MitraClip Guide inserted.
- Setup stabilizer and silicone sheet. Hand MD 60ml syringe with short extension tubing for aspiration.
- Amplatz wire and dilator removed. Clip inserted.
- Drips should be maintained at 1drip every 4seconds. If bubbles are seen on echo, turn drips down.
- When clip is being deployed turn room lights up and drips up.
- Bullet list of typical procedure steps
- More steps
Inset alternative steps or notes Start line with a space More spaces inset more
APPROVED: MD initials MM/YY