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Basicly, Mega blast, ipecac, quadshot, Chocolate Milk and other nice stuff
But i skipped Mom's floor with a Telepill ... no polaroid, no chest, and even not a knife to cut my veins for this fail ^^ But the seed was really fun
I didnt ever see moms knife but maybe thats cos i rerolled one of the item rerollers. Still got incubus and brimstone early on, then spoon bender plus a whole host of damage ups. Easy mega satan kill!
You don't need an angel room to fight mega satan. Sacrifice rooms spawn them after you hit yourself on the spike 9 and 11 times. (assuming you have afterbirth)
It's situational.