A puncturing device comprising: a resin tube having a distal end and a proximal end, and extending in a longitudinal direction; a metal tube disposed in a lumen of the resin tube; a metal member disposed at a distal end portion of the metal tube; and a metal tip disposed at a distal end portion of the metal member, wherein a flow path is present between an inner surface of the resin tube and an outer surface of the metal member and is in communication with a lumen of the metal tube, the resin tube further includes an opening portion through which the flow path and outside of the resin tube are in communication with each other, and the opening portion is present on a distal side relative to a distal end of the metal tube and on a proximal side relative to the proximal end of the metal tip.

Provided herein are recombinant virion arrays comprising human membrane bound proteins that retain their native conformations and/or interactions, recombinant HSV-1 virions, and methods of use including high-content, high-throughput assays for screening for ligands and/or drugs that bind human membrane bound proteins, diagnostic assays, proteomic assays, and biosensor assays. Also provided are recombinant HSV-1 virions comprising an envelope comprising a plurality of heterologous membrane bound proteins that retain their native conformations and/or interactions as well as recombinant HSV-1 bacterial artificial chromosome (BAC) clones encoding heterologous membrane polypeptides.

A transseptal punch with a steering mechanism within the punch, such that punch can be steered and deflected within a guide catheter during delivery, to avoid skiving of the guide catheter inner wall by passage of the punch tip through the guide catheter. The punch can be advanced through a body lumen in its straight configuration and then be selectively articulated or curved to permit negotiation of tortuous curvature or to permit optimal approach or access to a puncture site. The punch is able to create holes in the atrial septum of the heart or other structures and is easier to use than punches that are pre-curved near their distal tip since it is easier to advance through accessory catheters.

A medical device that has high pushing performance is capable of forming a hole in a biological tissue in a living body, is capable of being arbitrarily shaped, and is capable of suppressing a kink. The medical device may be used to form a hole in an oval fossa in a living body. The medical device includes: a hollow dilator made of resin; a core made of metal that is disposed in a part in a circumferential direction of the dilator and extends in a long axis direction of the dilator; and an output unit that is disposed in a distal portion of the dilator and outputs energy to form the hole in the oval fossa, in which the core is embedded in between an inner peripheral surface and an outer peripheral surface of the dilator, and the core has conductivity and is electrically connected to the output unit.

A transseptal punch with a steering mechanism within the punch, such that punch can be steered and deflected within a guide catheter during delivery, to avoid skiving of the guide catheter inner wall by passage of the punch tip through the guide catheter. The punch can be advanced through a body lumen in its straight configuration and then be selectively articulated or curved to permit negotiation of tortuous curvature or to permit optimal approach or access to a puncture site. The punch is able to create holes in the atrial septum of the heart or other structures and is easier to use than punches that are pre-curved near their distal tip since it is easier to advance through accessory catheters.

A medical device and a treatment method are disclosed which allow easy formation of a hole using energy and easy expansion of the formed hole without loss of tissue and allow an increase in working efficiency. A medical device is disclosed for forming a hole in a tissue in a living body and expanding the hole, the medical device including: a dilator having a first lumen formed inside and having a tip portion in which the first lumen opens on a distal side; and an output unit that outputs energy for denaturing the tissue and forming a hole, in which the output unit is disposed on a tip portion and formed discontinuously in the circumferential direction of the tip portion, and the outer diameter of the tip portion gradually decreases toward the distal side.

Apparatus and methods for ablation efficacy are described herein where a hood having a deployable elongated feature can extend beyond a distal face of the hood. The elongated feature can channel the energy to the deeper regions within the tissue (such as trabeculated regions or other tissue structures) such that the energy can be delivered to the target tissue despite small or large irregularities in the target tissue surface (or region) and/or changes in the relative distances between the hood and the target tissue.

A medical system includes a sheath and a dilator. The sheath includes an elongate body having a proximal portion and a distal portion, and a lumen extending from the proximal portion to the distal portion. The dilator is movable within the lumen. The dilator includes an elongate body having a proximal portion, a pre-formed distal portion, and a tapered distal tip. One or more electroanatomical mapping electrodes are located on the pre-formed distal portion. The one or more electroanatomical mapping electrodes is configured to electrically couple with an electroanatomical mapping system. The pre-formed distal portion has a substantially linear configuration when confined in the sheath, and an arcuate configuration when unconfined.

The present disclosure relates to a RF ablation catheter for septal reduction therapy having a cooling effect, and more particularly, to a RF ablation catheter for septal reduction therapy that is for performing RF ablation, in which RF energy is applied to an interventricular septum, for septal reduction therapy such as therapy for hypertrophic cardiomyopathy, which is a disease in which an interventricular septum of the left ventricle of the heart of the animal or human body thickens, therapy that requires reduction of an interventricular septum, or therapy for ventricular tachycardia. Also, the present disclosure relates to a RF ablation catheter for septal reduction therapy having a cooling effect that is for preventing carbonization of a tissue of the body (interventricular septum) around an electrode. An exemplary embodiment of the present disclosure provides a RF catheter for septal reduction therapy, the RF catheter including: an intra-septal part in which a tapered tip which becomes thinner toward an end thereof is formed at an end of a distal part and one or more electrodes are formed at positions on an outer circumferential surface that are adjacent to the tip; and a body part which is made of a soft material and has a guidewire lumen which passes through the intra-septal part from an inlet formed at the center of the end of the tip and has an outlet formed in a side surface, a coolant inlet lumen which is connected from a proximal part to an inner portion of the intra-septal part to allow a coolant to be injected from the outside and which has an open end, and a coolant outlet lumen which communicates with the coolant inlet lumen and has an exit formed in a side surface, wherein the guidewire lumen and the coolant inlet lumen do not communicate with each other and are partitioned from each other.

A method of perforating a tissue of a heart of a patient when an inferior approach to the heart is contraindicated. The method utilizes an electrosurgical apparatus and a delivery system comprising at least two dilators wherein a first dilator is configured for facilitating positioning of the electrosurgical apparatus adjacent the tissue and wherein a second dilator is configured for advancement through a perforation in the tissue. An outer diameter of the second dilator is substantially equal to or less than an outer diameter of the first dilator. The method comprises the steps of: (a) advancing the first dilator into the heart of the patient, from a superior approach, until a distal end of the first dilator is adjacent the tissue; (b) using the electrosurgical apparatus, which is positioned through the first dilator, to create a perforation in the tissue by delivering electrical energy to the tissue; (c) advancing the distal end of the electrosurgical apparatus through the perforation; (d) withdrawing the first dilator; and (e) advancing the second dilator over the electrosurgical apparatus.