PDA Closure
From Bay Area Structural Heart Wiki
Spies/Daniels
- BIPLANE - Patients arms securely positioned above head , keeping brachial plexus injury in mind.
- Acist setup 100% contrast and naked-manifold for RH pressures
Sheaths:
- Micropuncture
- (2) 6F Pinnacles
- 6F 180 deg TorqueView OR 7F 90 Deg TorqueView (ASK MD)
Wires:
- .035 x 260 J Wire
- 260 angled glide
Catheters:
- 6F pigtail
- 6F JR4 diagnostic
- 6F JR4 guide
- 6F MP2 guide
- 6F PA catheter
- 5F IM diagnostic
Misc. Supplies:
- 30mm Snare
- Ultrasound probe cover
- (2) 3-way stop cock
- (2) Co-Pilots
- Acist setup
- Naked manifold
- Perclose
PLUG Devices: OPEN WHEN MD REQUESTS
Procedure Steps
- 6F venous and arterial access on same side.
- PA catheter advanced (If RHC needed performed now)
- Pigtail to LV for EDP and pullback
- Pigtail to arch for DSA 15/30 acist settings. (Change settings from CARD Alte. to DSA body 4, to accomplish bi-place cine)
- Pigtail removed over Glidewire
- 5F IM advanced over glide on arterial side
- PA catheter removed over the 260 J wire
- JR4 Guide catheter advanced over 260 J to the PA
- Snare advanced thru the JR4 Guide and advanced to the PDA
- Glidewire snared and pulled from the AO thru the PDA to the venous side, externalized
- JR4 and snare removed
- 5F IM exchanged for the 6F MP2 Guide
- DSA 10/10 on acist thru the MP
- MP and 6F sheath removed, TorqueView sheath advanced across the PDA to the venous side
- Glidewire removed and plug advanced
- DSA performed to confirm fit and position
