Devices used to provide transseptal access are disclosed. The devices may comprise at least one cannula, a needle, and a handle. The cannula and the needle may be configured to be inserted through a dilator while not damaging a lumen wall of the dilator. The handle may be configured to lock the needle in a retracted position. The devices may be configured to telescopically advance the needle through an atrial septum.

Systems and methods for delivering a device for regulating blood pressure between a patient's left atrium and right atrium are provided. The delivery apparatus may include a first catheter, a hub having one or more engagers disposed thereon configured to releasably engage with a first expandable end of the shunt in a contracted delivery state within a lumen of a sheath, and a second catheter extending through a center lumen of the first catheter and the hub, wherein the first catheter, the hub, and the second catheter are independently moveable relative to the sheath. The inventive devices may reduce left atrial pressure and left ventricular end diastolic pressure, and may increase cardiac output, increase ejection fraction, relieve pulmonary congestion, and lower pulmonary artery pressure, among other benefits. The inventive devices may be used, for example, to treat subjects having heart failure, pulmonary congestion, or myocardial infarction, among other pathologies.

Disclosed herein are systems, devices, and methods for treating heart failure. In some variations, a catheter for forming an anastomosis in a heart may comprise a first catheter comprising an electrode. A second catheter may be slidably disposed within the first catheter. The second catheter may comprise a barb and a dilator comprising a mating surface configured to engage the electrode.

The present technology is generally directed to interatrial shunting systems and associated devices and methods. For example, a system configured in accordance with embodiments of the present technology can include a shunting element implantable into a patient at or adjacent a septal wall. The shunting element can have a lumen that fluidly connects a left atrium and a right atrium of the patient to facilitate blood flow therebetween when the shunting element is implanted. In some embodiments, the system further includes a flow control element to selectively control blood flow between the left atrium and the right atrium.

A self-contained, battery powered transseptal crossing system is disclosed. An elongate, flexible electrically conductive needle body has a proximal end and a distal end. An insulation layer surrounds the sidewall and leaves exposed a distal electrode tip. A generator is configured to deliver RF energy to the electrode tip, and includes a processos configured to take impedance measurements at the tip to confirm contact with the intra atrial septum and / or confirm entry into the left atrium.

Various aspects of the present disclosure are directed toward apparatuses, systems, and methods for cardiac device anchoring and more specifically to accessing and anchoring in the pericardial space.

An apparatus includes an elongated medical dilator including a cautery device configured to selectively form, by cauterization, a tissue passage through a tissue portion of a living body. The elongated medical dilator also includes a dilation device configured to dilate the tissue passage once the cautery device selectively formed the tissue passage.

Systems, devices, and methods are provided for transseptal access of septa within a patient. The device can be advanced to a septum, e.g., towards a fossa ovalis. Instead of applying positive pressure to “tent” the septum, a negative pressure is applied to a lumen within a sheath, e.g., within an elongated member slidable within the sheath, via a negative pressure source such as a syringe on the proximal end of the sheath. This results in the septum pulling inward. The sheath employs a stationary needle-like central core component contained within the lumen of the sheath that punctures the septum when the same is pulled passed it by the negative pressure. The stationary needle-like central core component may be hollow and may form a portion of the elongated member or may be coupled to a distal end thereof.

Apparatus for excising and removing a clip or suture joining leaflets of a native heart valve. The apparatus includes an elongate shaft configured for remote access to a native heart valve, the elongate shaft having a proximal end, a distal end, and a lumen defined therein, and a clamp at the distal end of the elongate shaft, the clamp configured to receive a clip or suture joining native leaflet tissue, the clamp including a passageway extending along a length thereof in communication with the lumen. The apparatus further includes a cutter moveable within the passageway to encompass a clip or suture joining native leaflet tissue received within the clamp and cut native leaflet tissue proximate the clip or suture.

A needle assembly is configured to be movable into a cavity of a patient having a biological wall. A distal tip section extends from the needle assembly. The distal tip section is configured to form a pass-through hole extending through the biological wall of the patient (as, or while, the needle assembly is urged to move toward the biological wall). The distal tip section is also configured to prevent (at least in part) the removal of a free-floating tissue core from the biological wall as the pass-through hole is formed by the distal tip section.