St. Joes Stockton TAVR

TAVR Pack list

Stock Room

• Basic Pack (Large table cover)
• Marquis Blue Stopcock x2
• Gray needle (22 gauge)
• U/S Probe Cover
• Micropuncture Introducer Set x2
• Transducer
• .035 J Wire 145
• .035 / Wire 260 cm X1
• .035 LLT Guide wire 145CM X1
• Lunderquist Extra Stiff Wire Guide double curve 260CM X1 -not Punnam Ali
• Amplatz Extra Stiff Wire Guide .035 260 -Edwards
• Confida- Medtronic or Mahadevan

Room 1

• 6 FR Terumo Pinnacle Ref RSS602 x2
• 8 FR Terumo Pinnacle Ref RSS802 x1
• 60CC Syringe X2 (2-extra for Buhari)
• 24" tubing
• 48" tubing
• Acist touch kit long pack

Supply cart by break room

• Mynx - Not Mahadevan
• 6 FR Per Close Proglide x2 - Extra Perclose for Mahadevan
• 6fr AngioSeal
• Basic Pack III (also in OR stock room)

Edwards

Edwards pacer supplies

• Remington pacer cables
• Repositioning Sleeve
• 5FR (197MM) Pacel pacing catheter
• 2-3 Blue Sterile Bowls (Disposable)
• 6 FR Terumo Pinnacle REF. R55602 X1
• 2 24" Tubing

Edwards setup

• 20ml contrast to setup table for mix
• 2x60cc syringes
• 30cc syringe

Medtronic

Open

• Confida wire
• Alligator clips

Standby

• Pacer setup
• Venous sheath and lines

Setup

Note: OR nurses will open light covers, arterial extension, and dressing supplies from their stock.

1. Ensure you have 2 long tables.
2. Back table pack to scrub table.
3. Basic Pack to valve prep table.
4. Open everything - RN's will help.
5. Set tables and cover.
6. When Pt. enters Anes. and RN's will hook pt up and shave and prep.
7. Full 3 minute prep pause
8. Drape

Procedure

• Full OR prep, but standard CCL drape.
• RN opens venous extension.
• Drs get access and help themselves.
• 6fr to dilate
• 6fr venous
• Pre close
• 8fr sheath arterial
• Pigtail
• Crossing catheter
• Vein access
• Pacer
• Lunderquist -> sheath
• Lund out
• Position pigtail
• Cross valve
• 260j
• Pigtail across valve
• Amplatz in
• Load valve
• Advance valve on balloon
• Deploy
• Fluoro Save!
• Echo
• Remove system
• Pigtail for gradient
• Short j's
• Perclose
• Angioseal for 6fr artery
• Mynx for vein
• Cleanup

Notes

Ali / Punnam

• Amp ss for big sheath no lunderquist
• 14fr. sheath dilator first, not 16fr
• Confida

Procedural differences

1. access left groin first six French times two
2. pigtail up then roadmap to shoot right groin for stick
3. Wet towels x3
4. 8 French dilator for R groin-> Perclose x2 -> 8fr sheath
5. Amplatz SS in 8fr dilator to R groin alongside short j
6. after device deployed, pull confida wire and replace with long J