Lampoon

Procedure to lacerate the Mitral valve leaflet to clear LVOT obstruction in the setting of TMVR.

This equipment list should be considered as add-on equipment to a TMVR procedure. It is not a complete procedure list!

Contrast use is unlikely for valve in valve and valve in ring variants.

• Astato 300cm
• Amplatz Super Stiff 1cm tip
• Piggyback converter catheter
• Runthrough 300
• Bovie Pen
• 2 - Touhy-Borst
• 2 - Regular stopcock
• 2 - 12” Extension
• 2 - 60cc syringe
• 2 - .014 torque device
• 18 x 30 En-Snare
• Agilis (Ask before opening)
• 6fr balloon wedge catheter
• (2) 7fr JL3.5 guide
• Langston Pigtail
• 6fr. MPA diagnostic
• 6fr. X 10cm Pinnacle
• 14fr. Dry Seal
• 12,14,16 mm x 40 balloons (Ask for size) Mustang or XXL balloons

Procedure- rough synopsis from past case notes

• LFV accessed and 8F sheath inserted
• RFA accessed and 6F sheath inserted
• RFV accessed, preclosed, and Esheath inserted.
• RHC performed
• Langston used to measure LV/AO
• SL1 advanced and transseptal needle inserted. Transseptal puncture.
• .032 exchange wire advanced. Dilator removed, MPA inserted to PV
• Wire exchanged for Amplatz SS. MPA removed.
• Septostomy performed.
• 6F balloon wedge advanced through Agilis.

***notes difficult to follow- will continue procedure steps after reviewing images. JD 3/27***

Standby

• 7fr JR4 guide