WatchmanEPmisc

last updated 9/5/24 ac/jc/zr

While the Cath Lab's Watchman Page provides the majority of what you need, this page has some additional info.

---workflow change 4/1/24 8/26/24---

Set fluoro to 10p/s, Card Alt. 2 x RFV access. Please make sure to separate the wires by 10mm.

If DrySeal: 8F RFV, preclose, upsize to Dryseal, 230cm VersaCross thru Dryseal, upsize VersaCross to fixed Watchman sheath

If TrueSteer: 8F RFV, preclose, upsize to 230cm VersaCross, cross septum, upsize to TrueSteer

Either way, drop 10F 30cm Check-Flo for Philips VeriSight Pro ICE Catheter. As of 9/5/24 we're working on attaching a 10F Mullins or SL0/SL1 to VNC which we'd upsize to from Check-Flo for a second transeptal puncture for ICE. Locate a catheter, ICE display connection cable+adapter (DP-DVI), and the cardboard box in the watchman cart for noninvasive prior to case.

RN:

-Large bottle of visipaque + contrast spike

-3x 500cc bags of normal saline with 5000 units of heparin per bag (2 for table, 1 for transducer)

-1x 1L bag of saline with 2000 units of heparin, premade in pyxis (manifold saline - on 1L pressure bag)

-Lido w/ Epi

-Check with PACU for pre-op - NS 500cc bolus, 4 chewable aspirins, precedex

-Labs day of: PT-INR, Type & Screen

-Labs within 30 days: CBC, BMP, EKG

-Tell Anesthesia - Ancef + General Anesthesia

-Tell PACU - shave groins + subxiphoid

Pull list

--temporary/new 8/26/24 --

--check with MD whether to drop16f DrySeal OR TrueSteer (dropped by rep - deflectable watchman delivery sheath),

--10f 30cm checkflo, Verisight ICE, ice sleeve, a second perclose for the ice sheath (postclose)

--0.0 silk + needle driver only if using DrySeal

-6fr Straight Pig

-Contrast Spike (ref 90400039)

-3 Port Manifold (ref 63160612)

-Long Versacross kit (230cm) (ref VXSK0032)

-Perclose (1 if Woods only, 2 for Spies)

-3cc syringe for ACT

-EP Pack

-Micropuncture

-8F pinnacle (just for dilator)

-Ultrasound Cover

-Pressure Transducer w/Tubing

-RadPad

-Rampart Cover

-Light Handle Cover

-The CCL Watchman Page mentions use of a 150 J Cordis - but Dr. Woods has been loading the 5fr pigtail over the 230cm versacross pigtailwire directly as of 4/2023.

-exofin on standby

-Ioban

-Ground pad, defib, dots, sp02, bp cuff