TAVI - JenaValve
From Bay Area Structural Heart Wiki
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
Anesthesia- MAC is our new standard. Have ICU on standby.
Sheaths:
- 5Fr Micropunture Kit
- 7Fr Slender Sheath (Verify secondary access will be radial)
- 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
- Verapamil for radial access
- Epinephrine 10mcg/ml in red medallion syringe (From anesthesia)
Miscellaneous Supplies
- 3-port manifold kit (only if shooting coronaries)
- Acist hand control
- 3 L cold NS
- (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
- (4) bowls (cold saline in all 4 * NO need for contrast mix on back table *)
- Suture removal kit (for back table)
- Alligator cables for pacing
Backup Transvenous pacemaker supplies *ON STANDBY*
- 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
