TMVI - Encircle Sapien M3
From Bay Area Structural Heart Wiki
Protip: Need Alcohol in lab for this procedure!
Template:SAVE ALL RESEARCH EQUIPMENT PACKAGING
DANIELS
Sapien M3
| Short Procedure Name | |||||
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| Anesthesia | Imaging | Access | Pre-Procedure | ||
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Sheaths:
Open:
- Micropuncture set
- 5/6 Slender Daniels sheath
- 8f Pinnacle
- 8fr x 35cm Brite-Tip
- 8.5fr SL1 transseptal sheath
Wires:
Open:
- (2) .035 150CM J WIRE
- (1) .035 260CM J WIRE
- (1) .032 260CM J WIRE
- (1) SAFARI 2 WIRE
- (1) AMPLATZ SUPER STIFF 1CM TIP
Standby
- Baylis ProTrack wire
CATHETERS
Open
- (2) 6F STRAIGHT PIGTAIL 110CM
- 5F MPA1
- 6F ballon wedge
Standby
- 6F MPA1 125cm
PACING
- 5F JOSEPHSON PACING CATHETER
- EP QUAD CABLE
- DUAL RED/BLACK REMINGTON PACING CABLE
- (2) PACER BOXES
VALVE TABLE
- (5) STERILE BOWLS (3- 0.9% SALINE, 1-HEP SALINE, 1-15% CONTRAST MIX)
- (1) 90 INCH DRAPE
- 1.5L NORMAL SALINE
- 500ML HEPARINIZED SALINE
- (2) 60ML SYRINGE
- (2) 20ML SYRINGE
- (1) HIGH PRESSURE STOPCOCK
- 30ML CONTRAST (MIX WITH 170ML HEP SALINE FOR 15% CONCENTRATION)
VALVE- SUPPLIED BY EDWARDS
- INDEFLATOR
- CRIMPER
- E SHEATH
- DELIVERY SYSTEM
- VALVE
TRANS SEPTAL
- BAYLIS NEEDLE LARGE CURVE C1
- BAYLIS MACHINE
- BAYLIS CABLE
- GROUNDING PAD
SEPTAL DILATION
Open
- 14X4 ARMADA BALLOON- prepped
- PRESTO INDEFLATOR
Standby
- TORQUEVUE 45DEGREE DELIVERY SYSTEM (9F OR 10F)
- 10MM, 14MM, 18MM SEPTAL OCCLUDER
ADDITIONAL SUPPLIES
Open
- (1) PERCLOSE
- 3 PORT MANIFOLD
- ACIST- 100% CONTRAST
- PROBE COVER
- STAT LOCK WITH STRING SECUREMENT
- (2)0-Prolene
- CHLORAPREP AND PREP TRAY
- (2) FLUORO DRAPES (FOR LATERAL BASE AND IVY POLE ONCE IT IS MOVED TO THE END OF THE FIELD)
- 36X36 BANDBAG (FOR LATERAL DETECTOR)
- 2L HEP SALINE ON ALARIS PUMP - Click this link to see pressure adjustment process
- That's right, I said IVY pole.
- (2) Alaris pump
- (2) Heparin tubing
- (2) 72” pressure tubing
- Swiftlink cover
MEDICATIONS
- BUPIVACAINE/LIDOCAINE MIX
- EPINEPHRINE 10MCG/ML IN RED SYRINGE ON BACK TABLE
- ROTAGLIDE 10ML (PRE VALVE)
STANDBY EMERGENCY ECMO SUPPLIES
- 16F ARTERIAL CANNULA
- 21F VENOUS CANNULA
- (2) PERCLOSE
- ECMO INSTRUMENT TRAY
- AMPLATZ SUPER STIFF
STANDBY PERICARDIOCENTESIS SUPPLIES
- EYE DRAPE
- CHIBA NEEDLE 10CM 18G
- SKATER INTRODUCER SET
- BARD LOCKING PIGTAIL 6F OR 8F
- (3) 60ML SYRINGES
- STOPCOCK
- AMPLATZ SUPER STIFF 180CM
STANDBY PARAVALVULAR LEAK REPAIR SUPPLIES
SEE MITRAL PARAVALVULAR LEAK REPAIR
- AMPLATZER VASCULAR PLUG 2 SIZE 8-18 AVAILABLE
PROCEDURE
- Patient prepped from navel to knees in sterile fashion.
- ISOCENTER XRAY
- Access obtained with u/s
Typical sites:
- 6F Right radial for Pigtail
- 8F 35cm LFV for transcutaneous pacing
- 20F RFV E-sheath for valve delivery
- Dilate with 8F
- Preclose
- SL1 inserted over .032 kit wire
- Baylis needle inserted through SL1 and atrial septum puncture performed.
- Needle removed
- 5F MPA advanced over .032 wire
- 1cm Amplatz Super Stiff advanced and MPA and SL1 removed
- Edwards Guide Sheath (GS) advanced
- Pigtail advanced through 6F sheath and LVgram @ 15/45 performed
- Change ACIST to 5/5 after lvgram
- Mitral annulus denoted on live monitor screen in A plane
- DDS prepped
- 1L Hep. Saline (2U/2ml) bags with pressure bags spiked with heparin tubing, flushed, and attached to pump
- Alaris settings 200ml/hr occlusion pressure limit 300mm Hg
- Pressure tubing attached to stopcock and DDS
- Swiftlink cover installed over pressure tubing and secured ~18” from off-table end
- After hookup and flush, Swiftlink cover can be slid over heparin tubing for additional slack on the table.
- Dock Delivery System (DDS) advanced through GS
- Change fluoro to 4fps once DDS is in place and dock deployment begins.
- Dock deployed in a timely fashion ;)
- Temp pacer inserted and tested.
- DDS removed and Pigtail inserted over exchange J for valve crossing
- J wire exchanged for Safari 2
- Pigtail and GS removed
- 14mm balloon advanced for septostomy
- Balloon removed
- Valve delivery system advanced
- Valve deployed. Septum evaluated with echo for shunting and PVL.
- remind MD to lower FIO2***
- Delivery system removed and MPA inserted for LA pressure measurement.
- RHC performed with 6F swan to evaluate ASD
- All equipment removed
- Preclosure closed and stitch to RFV, manual pressure LFV
- Tegaderm both sides.
APPROVED: MD initials MM/YY
