TAVI-JenaValve

Note: Ensure Milena and the research team are in the lab at the time the patient enters the room. This is to expedite the valve prep.

Daniels/Spies - Draft

ACIST A1000V SYRINGE USED WITH 50/50 CONTRAST MIX

Bipolar Pacing for ALL Jenavalve implants. (Because JenaValve sheath doesn't allow for electrical conduction.)

Anesthesia- MAC is our new standard. Have ICU on standby.

Sheaths:

• 5Fr Micropunture Kit
• 6Fr x 10cm sheath
• 8Fr x 10 cm sheath
• 18F Cook Sheath *** On standby

Wires:

• (2) Cordis 150J
• Cordis 260J
• Safari 2
• Lunderquist *** On Standby

Catheters:

• 5Fr MPA
• 5F MBP *** On standby
• 5F & 6F Angled Pigtail
• 6F Marker Pigtail *** ASK BEFORE OPENING (From IR . If you only have a 5F drop PSI to 400.)

Medications on table:

• Lido/Bupivicaine 50/50

• Epinephrine 10mcg/ml in red medallion syringe (From anesthesia)

Miscellaneous Supplies

• 3-port manifold kit (only if shooting coronaries)
• Acist hand control
• 1 L warm saline (on standby)
• 3 L cold saline
• (2) 60ml syringes (for back table)
• (2) 20ml syringes (one for back table one for front)
• stopcock (for back table)
• co-pilot (for back table)
• Roto-tubing (for back table, will be tossed over from table and spiked in pressure bag of hep saline)
• 500ml hep saline on pressure bag for delivery system
• (3) Perclose
• (5) bowls (cold saline in all 5 * NO need for contrast mix on back table *)
• Suture removal kit (for back table)

Transvenous pacemaker supplies

• 8F Brite tip Sheath
• 5Fr Josephson Pacing catheter
• Dual Red/Black Pacing Remington cables
• EP Quad Cable

PROCEDURAL INFO:

• Standard TAVR access. (Jenavalve sheath is 20F)
• Pigtail in contralateral access, injection for coplanar angle.
• Change injector to 10/10 after coplanar angle established.
• Pigtail exchanged for MPA
• Pigtail advanced on primary side for valve crossing over J wire
• J-wire exchanged for Safari and pigtail removed
• JV Guide sheath inserted (when ACT above 250)
• Delivery system attached to pressure bag via co-pilot on front table.
• Valve inserted and deployed
• Delivery system pulled back into JV sheath
• Possible exchange for 18F sheath, re-advance the MP to remove the safari