Intrepid valve

From Bay Area Structural Heart Wiki

File:Intrepid supply list.pdf Note Note: This supply list is for Mitral

Setup Notes

  • Reps prep - ~ 1 hour!
    • 6 liters cold saline
    • Pressure bags x2 for device drips
    • Open ECMO tray for reps
    • Mitra-clip plate and stool
  • Use Coban to attach long table to short table end-to-end to make extra long table(drape first).
  • Surgical access
    • Neptune and Bovie
    • OR setup like carotid
    • Cut-down with plegeted purse-string
  • A/V access on opposite side
  • Monopolar pacing in LV via arterial access with Safari and apical pacing patch
  • Needs acrylic board and footstool. We can use the MitraClip one, but they will probably bring one as well.

Mitral

Open

  • TAVR pack
  • Back table cover
  • 6fr. Pinnacle
  • 8fr. Pinnacle
  • Micropuncture
  • 0.035x150 J-wire
  • 5fr. JR4 diagnostic catheter
  • Safari wire
  • Alligator clip pacing cable (Black clip stays on table; pass off red and plug to circ.)
  • Perclose

Procedure

  1. Surgical cutdown to RFV
  2. 18 gauge entry needle access -> 8fr. Sheath
  3. 150 J loaded in JR4 inserted
  4. J-wire removed for Lunderquist
  5. Intrepid sheath inserted over Lunderquist
  6. LFA access with micropuncture -> 6fr. Sheath
  7. Manipulate valve to pre-deployment position
  8. 150J loaded in JR4 -> LFA to cross Aortic valve
  9. J-wire out for Safari
  10. Safari positioned in LV and alligator clip attached (black to back)
  11. Pacing threshold tested
  12. Final positioning of valve and deployed while pacing.
  13. Safari and JR4 removed
  14. Intrepid sheath removed and surgically closed
  15. Perclose to LFA