Intrepid valve

File:Intrepid supply list.pdf Note: CALL MILENA AS SOON AS PATIENT IS IN THE ROOM!! 415-368-3094

Intrepid table Setup

Intrepid table Setup

Intrepid table Setup

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
• Stool edge is 100cm from mid-sternum

Open

• TAVR pack
• Back table cover
• 6fr. Pinnacle
• 8fr. Pinnacle
• Micropuncture
• 0.035x150 J-wire
• 5fr. JR4 diagnostic catheter
• Safari wire
• Steelcore wire (10/6/22 DD tested RV pacing, may not need don't drop)
• Watchdog (10/6/22 DD tested RV pacing, may not need don't drop)
• Alligator clip pacing cable (Black clip stays on table; pass off red and plug to circ.)
• 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. Surgical cutdown to RFV
2. LFA access with micropuncture -> 6fr. Sheath
3. 18 gauge entry needle access -> 8fr. Sheath to RFV
4. Maybe Pigtail advanced for RV-gram (Reference image. Lunderquist advanced thru pigtail if used.)
5. 150 J loaded in JR4 inserted
6. J-wire removed for Lunderquist
7. Intrepid sheath inserted over Lunderquist
8. Manipulate valve to pre-deployment position
9. 150J loaded in JR4 -> LFA to cross Aortic valve
10. J-wire out for Safari
11. Safari positioned in LV and alligator clip attached (black to back)
12. Pacing threshold tested
13. Final positioning of valve and deployed while pacing.
14. Safari and JR4 removed
15. Intrepid sheath removed and surgically closed
16. Perclose to LFA