CoreValve Transcatheter Aortic Valve Implantation System Preparation and Loading Procedure ® Please refer to Instructions for Use for complete procedural information. Step 2 Normal Indicator Indicator Showing Freeze Damage Step 3 Step 6-7 Step 9 Macro Slider 10 Catheter Flush 1. Before removing the CoreValve Bioprosthesis from its packaging, carefully inspect the packaging for any evidence of damage. If there is evidence of damage, do not use the valve. 2. Inspect the freeze indicator located within the packaging for any evidence of damage. If there is evidence of damage, do not use the CoreValve Bioprosthesis. Step 12 3. Remove the CoreValve Bioprosthesis from its container by carefully grasping one of the frame loops with a pair of blunt-tipped forceps. DO NOT use the forceps to grasp the tissue portion of the valve. 4. Compare the serial number on the container with the serial number on the tag attached to the CoreValve Bioprosthesis. If the serial numbers do not match, DO NOT use the valve. 5. Remove the serial number tag from the CoreValve Bioprosthesis and set it aside. Ensure that the suture that was used to secure the serial number tag to the CoreValve Bioprosthesis is completely removed from the valve. Step 13 = CoreValve Bioprosthesis loading steps should be performed under chilled (0-8°C) saline 6. Rinse the CoreValve Bioprosthesis by immersing it in a sterile basin containing 500 mL of fresh saline. Gently agitate the valve by hand for 2 minutes to ensure that the glutaraldehyde and alcohol are thoroughly rinsed from the valve. 7. Repeat step 6 two more times (for a total of 3 times) using 500 mL of fresh saline each time to ensure complete removal of glutaraldehyde and alcohol from the CoreValve Bioprosthesis. Step 15 Micro Knob 11 Guidewire Lumen Flush 8. Wipe the length of the Delivery Catheter System (DCS) with a moist (saline) gauze. 9. Use the macro and micro knobs on the handle to open and close the DCS. 10. Attach a stopcock to the distal luer-lock connection on the handle. Insert a 10-ml syringe filled with saline in the stopcock and flush. For DCS w/ AccuTrak™ Stability Layer, repeat flushing procedure for the second flush tube. Verify there is no leakage from the catheter, if leakage is observed use a new DCS. 11. Attach a 10-ml syringe filled with saline in the proximal luer-lock connection on the handle and flush. Step 17 Step 18 12. Advance the flared outflow tube over the DCS shaft. Step 19 19. Carefully withdraw the inflow tube and attach the exposed frame loops to the DCS tabs. Step 24 24. Advance the CoreValve Bioprosthesis into the inflow cone while holding the flared outflow tube. Step 27 13. Using chilled (0-8°C) saline, submerge and cool the 15. Once the CoreValve Bioprosthesis is fully inserted, CoreValve Bioprosthesis. Gently squeeze the outflow secure the outflow cap onto the outflow cone. part of the cold valve frame and insert into the outflow cone. Note: As applicable, all subsequent CoreValve Bioprosthesis loading steps should be performed under chilled (0-8°C) saline. 14. Slowly continue to insert the frame into the outflow cone. Step 20 20. Cover the frame loops and the top of the CoreValve Bioprosthesis struts with the capsule using the micro knob. Ensure that the outflow struts are all captured prior to advancing the capsule further. Step 25 25. Advance the CoreValve Bioprosthesis into the inflow cone until the outflow tube contacts the inside of the inflow cone. Step 21 16. Carefully insert the inflow tube (non-tapered) into the outflow cap. 17. Gently continue to advance the inflow tube until the frame loops begin to separate. 18. Insert the distal tip of the DCS into the inflow tube. Step 22-23 21. Advance the outflow tube over the radiopaque marker band of the capsule. Step 26 22. Remove the outflow cap and inflow tube from the outflow cone. 23. Move the outflow cone away from the CoreValve Bioprosthesis over the DCS towards the handle. Tip 26. Slowly advance the capsule over the CoreValve Bioprosthesis to within approximately 5 mm of the DCS tip. Tip: If the micro knob clicks, apply mild upward pressure to the macro slider and continue turning the micro knob. www.medtronic.com Tip World Headquarters Medtronic, Inc. 710 Medtronic Parkway Minneapolis, MN 55432-5604 USA Tel: (763) 514-4000 Fax: (763) 514-4879 Medtronic USA, Inc. Toll-free: 1 (800) 328-2518 (24-hour technical support for physicians and medical professionals) LifeLine CardioVascular Technical Support Tel: (877) 526-7890 Tel: (763) 526-7890 Fax: (763) 526-7888 E-mail: [email protected] Europe Medtronic International Trading Sàrl Route du Molliau 31 Case postale CH-1131 Tolochenaz Switzerland Tel: 41.21.802.7000 Fax: 41.21.802.7900 Canada Medtronic of Canada Ltd. 6733 Kitimat Road Mississauga, Ontario L5N 1W3 Canada Tel: (905) 826-6020 Fax: (905) 826-6620 Toll-free: 1 (800) 268-5346 Asia Pacific Medtronic International, Ltd. 16/F Manulife Plaza The Lee Gardens, 33 Hysan Avenue Causeway Bay Hong Kong Tel: (852) 2891 4456 Fax: (852) 2891 6830 [email protected] Latin America Medtronic USA, Inc. Doral Corporate Center II 3750 NW 87th Avenue Suite 700 Miami, FL 33178 USA Tel: (305) 500-9328 Fax: (786) 709-4244 UC201006084 EE © Medtronic, Inc. 2010 All Rights Reserved Not for distribution in the USA Printed in Europe CoreValve Bioprosthesis After Finished Load 27. Submerge the capsule into cold saline and flush the distal luer-lock connection on the handle. For DCS w/ AccuTrak™ Stability Layer, repeat flushing procedure for the second flush tube. 28. Slowly advance the capsule over the CoreValve Bioprosthesis until the capsule contacts the DCS tip. Remove the outflow cone and outflow tube from the DCS. Maintain the loaded CoreValve Bioprosthesis in cold saline until it is ready to be implanted in the patient. 201006084_EE.indd 1 Tip: If the micro knob has fully advanced the capsule and a small gap remains between the capsule and the catheter tip, position one hand below the capsule, stabilize the handle with the other hand and gently advance the capsule manually to close the gap. Maintain the loaded CoreValve Bioprosthesis in cold saline until it is ready to be implanted in the patient. CAUTION: The CoreValve® System is not available in the USA, Canada or Japan for clinical trials or for sale. Refer to Instructions for Use for a complete list of warnings, precautions and contraindications. CoreValve is a registered trademark of Medtronic CV Luxembourg S.a.r.l. AccuTrak is a trademark of Medtronic, Inc. 24/08/2010 14:26
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