St. Joes PFO

Punnam and Ali

Open

• Micropuncture
• 6fr Pinnacle
• 8fr Pinnacle
• 8fr ice
• 6fr MPA
• US probe cover x2
  • 1 for access
  • 1 for ICE
• 9frx25
• Pre close x2
• 8fr -> MPA
• Stiff glide
• Amplatz SS after cross
• 2L hep saline in pond
• 2x 50cc syringes

Procedure

1. Micropuncture and US for access
2. 6fr sheath
3. Preclose
4. 8fr sheath
5. Access #2
6. 6fr sheath
7. Preclose
8. 9fr sheath
9. Ice in 9fr
10. MPA and J wire to SVC
11. Exchange J for stiff glide
12. Cross
13. Advance MPA
14. Exchange stiff glide for Amplatz SS
15. MPA out
16. Prep Amplatzer sheath and device
17. Exchange MPA and sheath for Amplatzer sheath
18. Deliver device
19. Close