Intrepid valve
From Bay Area Structural Heart Wiki
Note: CALL MILENA AS SOON AS PATIENT IS IN THE ROOM!! 415-368-3094
File:Intrepid supply list.pdf
Note: TIMEOUT - Be sure that any temporary catheter across the tricuspid valve is removed prior to deployment
File:Intrepid supply list.pdf
Setup Notes
- Reps prep - ~ 1 hour! (Make sure reps are prepping valve WAYYY before we prep the patient)
- (6) liters cold saline
- (2) Pressure bags with NS for device drips
- (3) bowls with 500ml NS in each
- (1) 60 cc with 30ml of Hep Saline the other two are for Saline.
- Pickups for back table
- Mitra-clip plate and stool provided by reps (Stool edge is 100cm from mid-sternum)
- Use Coban to attach long table to short table end-to-end to make extra long table(drape first).
- Surgical access
- Monopolar pacing in LV via arterial access with Safari and apical pacing patch
Open
- TAVR pack
- Back table cover
- Micropuncture
- 6fr. Pinnacle
- 8fr. Pinnacle
- Safari
- 0.035 x150 J-wire
- Lunderquist DC 260cm
- 5Fr JR4 diagnostic catheter
- 5Fr angled pigtail
- Alligator clip pacing cable
- (3) 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
- 6Fr Sheath RFA with micropuncture
- 8Fr Sheath RFV with 18 gauge entry needle access
- RFV Pre-closed x 2
- 150 J loaded into perclose and 8Fr sheath in RFV
- JR4 advanced to SVC for wire exchange.
- J-wire removed for Lunderquist.
- 40Fr Dilator in and out.
- Intrepid sheath inserted over Lunderquist
- Manipulate valve to pre-deployment position
- 150J loaded in Pigtail -> LFA to cross Aortic valve
- J-wire out for Safari
- Safari positioned in LV and alligator clip attached (black to back)
- Pacing threshold tested
- Final positioning of valve and deployed while pacing.
- Safari and pigtail
- Intrepid sheath removed and perclose completed. May need a 2-0 prolene for mattress stitch.
- Perclose to RFA
