A method is provided for puncturing a fossa ovalis of a heart, the method including inserting a catheter into a right atrium of the heart, and advancing a distal portion of the catheter toward an interatrial septum of the heart. A flexible longitudinal member is slid through openings disposed at the distal portion of the catheter, such that the flexible longitudinal member is made to loop around a portion of an inside perimeter of the fossa ovalis. While the flexible longitudinal member is looped around the portion of the inside perimeter of the fossa ovalis, a hole is punctured in the fossa ovalis at a puncturing point.

Described here are devices, systems, and methods for forming a fistula between two blood vessels. Generally, the systems may comprise a first catheter and a second catheter, which may comprise one or more fistula-forming elements. The first and second catheters may comprise one or more magnetic elements, which may be used to assist in bringing the first and catheters in closer proximity to facilitate fistula formation. In some variations, the magnetic elements may have magnetization patterns such that the flux generated by the magnetic elements is locally concentrated. In some instances, the system may comprise a magnetic control device, which may comprise a magnet, and may be used to increase or create an attractive force between the first and second catheters.

Apparatus for puncturing a fossa ovalis includes a catheter, which has a distal portion that is shaped so as to define a catheter distal end opening at a distal end of the catheter, and first and second lateral openings. The catheter is shaped so as to define a central catheter lumen open through the catheter distal end opening. A flexible longitudinal member passes from a proximal portion of the catheter to the distal portion of the catheter, out of the first lateral opening, and into the second lateral opening, so as to form a loop outside the catheter. A puncturing element is slidably disposed within the central catheter lumen, and is configured to puncture a hole through the fossa ovalis by being advanced out of the catheter distal end opening and through the fossa ovalis. Other embodiments are also described.

To provide a catheter having a simple structure capable of excising an atheroma in a blood vessel and capable of obtaining ultrasonic images of a blood vessel. [Solution] A catheter 10 has a shaft 11 having an opening 20 in a part of the side wall on the distal end side, a cutter 12 which is located in the vicinity of the opening 20 in the internal space of the shaft 11 and which can move in the axial direction 101 of the shaft 11, a balloon 23 which is disposed on the side opposite to the opening 20 with respect to the axis of the shaft 11 and which outwardly expands from the side wall of the shaft 11, and a phased array ultrasound probe 17 disposed along the circumferential direction 102 of the outer peripheral surface of the side wall in the vicinity of the opening 20 at least on the same side as the side where the opening 20 is provided with respect to the axis of the shaft 11.

The disclosed apparatus, systems and methods relate to an anterior mitral valve leaflet laceration catheter. The catheter has a plurality of lumens so as to allow for the introduction of the device via a guide wire, the inflation of a balloon and the manipulation of an introducer having a curved distal end cutting portion that can be rotated into a charged position for the laceration of the anterior mitral valve leaflet.

Balloon catheters with an elongate shaft defining a hollow body have an inflatable balloon at a distal end thereof. The balloon has a plurality of internal chambers that are inflatable to differing pressures. When inflated, the balloon has a generally hourglass shape having a neck between a distal end and a proximal end and a port at the neck that is in open communication the hollow body of the shaft and in open communication with an environment external to the balloon. The balloon catheter is inflated in a lumen of a patient to its hourglass shape with its proximal and distal ends in direct contact with normal endothelium juxtaposed to a target lesion with the neck of the balloon at the target lesion. A cutting tool is deployed through the port and an opening having a flap is cut into the target lesion and the plaque is removed thereof.

A platform device for material excision or removal from vascular structures for either handheld or stereotactic table or robotics platform use may comprise a work element or elements configured to selectively open and close at least one articulable beak or scoopula configured to penetrate and remove intra-vascular materials or obstructions, or follow a central lumen of another device or over a wire in a longitudinal direction. Flush and vacuum tissue transport mechanisms may be incorporated as well as single or multiple arrays of image guidance elements, directional elements, ablation elements and other interventional assistance elements. A single tube or an inner sheath and an outer sheath which may be co-axially disposed relative to a work element may be configured to actuate a beak or beaks or scoopulas and provisions for simultaneous or differential beak or scoopula closing under their differential rotation may be incorporated.

A surgical apparatus for treating a vessel blockage in a vessel of a patient having an elongated member having an outer wall, a first hole at a distal portion and a second hole spaced proximally from the first hole positioned in a side wall. A first lumen is provided within the elongated member for blood flow through the second hole, through the lumen and exiting the first hole to maintain blood flow during treatment of the vessel blockage. A motor driven impeller is rotatable during blood flow through the first lumen to enhance blood flow as blood flows into the second hole positioned proximal of the vessel blockage and exits the first hole distal of the vessel blockage during injection of fluid through one or more openings to treat the vessel blockage.

An atherectomy catheter device includes an elongate body, a drive shaft extending proximally to distally within the elongate body, and a cutter attached to the drive shaft. The cutter includes a serrated annular cutting edge formed on a distal edge of the cutter and a recessed bowl extending radially inwards from the annular cutting edge to a center of the cutter. The recessed bowl has a first curvature. The cutter further includes a plurality of grinding segments extending inwardly from the distal edge within the bowl. Each of the plurality of segments has a second curvature that is different from the first curvature.

An interventional device for cutting tissue at a targeted cardiac valve, such as a mitral valve. The interventional device includes a catheter having a proximal end and a distal end. A cutting mechanism is positionable at the distal end, such as by routing the cutting mechanism through the catheter to position it at the distal end. The cutting mechanism includes one or more cutting elements configured for cutting valve tissue when engaged against the tissue. A handle is coupled to the proximal end of the catheter and includes one or more controls for actuating the cutting mechanism.