TEER with PASCAL

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Revision as of 00:29, 23 February 2024 by Warneh (talk | contribs)
Anethesia Imaging Access
General Fluoro, TEE 4F Femoral Vein for drawing ACT's

**If functional MR/low EF Anesthesia to obtain A line and femoral venous sheath not needed

Pre-Procedure Watchouts
** Tidal Volume during time-out!

Product prep and procedural information: https://edwardsglobal.showpad.biz/s/3MckUqAe

Big Equipment:

  • Left Heart Cath Pack
  • Non-Sterile stabilizer provided by Rep
  • Baylis generator

* NEW - Baylis Transseptal

  • VersaCross system
  • Grounding pad

Note Note: When using the Philips 4D ICE probe use a 10F 30 cm (from EP) sheath for ACT draws.

Misc supplies:

  • 4fr. Pinnacle sheath for ACT (not needed if anesthesia has an A line.)
  • Micropuncture
  • 8F Sheath for dilator only
  • (1)Perclose (If Spies is primary, NO perclose if Daniles is primary.)
  • 0-prolene Suture for woggle
  • (2) 60cc syringe
  • Sterile towel pack for back table
  • Naked 3-port manifold to measure LA pressure only
  • Fluoro cover to anesthesia IV pole or moving xray shield
  • U/S probe cover
  • back table cover
  • Large and small bowl for back table

Standby

  • 20fr. DrySeal for recovering wire to LUPV
  • 8x40 135cm Mustang balloon
  • 12fr. Short Cook sheath
  • SL1 sheath
  • Large curve Baylis needle
  • Baylis cable

Procedure

  • Anesthesia will obtain radial art line prior to draping.
  • Pre procedure TEE imaging performed
  • Prior to prepping patient, place MitraClip Plate (plexiglass board – hinge side up) under patient’s leg off center to the right. Place PASCAL Lift (step stool) over patients right leg. Make sure there is direct contact between stool and plate.
  • Prep patient and drape per usual. Drape anesthesia pole and/or xray shield.
  • GUIDE and CLIP prepped by rep.
  • Obtain RFV access, dilate with 8F, versacross pigtail wire inserted into perclose.
  • Versacross sheath advaned
  • Transeptal puncture, pigtail wire advanced
  • Versacross sheath removed, dilate over pigtail wire
  • Setup stabilizer.
  • PASCAL Guide sheath inserted. Asperate 45ml of blood with a 60 cc syringes than flush with 45ml of hep saline.
  • Amplatz wire and dilator removed. Clip inserted.
  • Set up for subsequent clips if needed.
  • Vicryl used for groin closure.

BACK TABLE SETUP

Rep's will need (2) 60 mL syringes, (1) 10 mL syringe, a large and small bowl.

All equipment prepped by reps.