Apparatuses and methods are disclosed for the perforation of a communication between the aorta and left atrium. The method includes introducing the apparatus, positioning the apparatus at a location along the aorta, and energizing the apparatus to create a perforation. For example, one method may include: introducing a flexible wire into the left atrium, advancing a dilator along the flexible wire to position the flexible wire adjacent a selected location along the aorta and energizing the flexible wire to create a perforation from the left atrium into the aorta.

The disclosed invention provides a transseptal insertion device which is suitable for facilitating precise and safe transseptal puncture of a cardiac interatrial septum. The transseptal insertion device includes a sheath that defines at least one lumen therein, one or more positioning balloons that are connected to a distal end of the sheath, a puncture member movably positioned within the at least one lumen, and a puncture member balloon located on the puncture member. The sheath has one or more deflation ports to deflate the one or more positioning balloons. The puncture member balloon, when inflated, is capable of sealing the one or more deflation ports in the sheath, permitting the inflation of the one or more positioning balloons. When the puncture member moves toward fossa ovalis, the inflated puncture member balloon moves away from the deflation ports, allowing the positioning balloons to be deflated.

A medical device capable of preventing a circumferential twist of an expansion body expandable in a radial direction and effectively pressing an energy transfer element against biological tissue. The medical device includes an outer tube, an expansion body expandable in a radial direction by contracting along an axis, a pulling shaft, and a plurality of energy transfer elements disposed in the expansion body. The expansion body includes a plurality of main struts in which the energy transfer elements are disposed, and distal side support struts and proximal side support struts which are connected to the main struts. A portion of each of the main struts between a force reception portion receiving a pulling force from the pulling shaft and the energy transfer element is substantially parallel to the axis when viewed from a radially outer side.

A pair of cooperating catheters are used together to provide rapid access to the Left heart for diagnostic or therapeutic interventions. The initial entry point for the catheter pair is the groin. The pair of catheters can be used to carry out an electrographic determination of the location of the Fossa Ovalis on the septum. Features on the Catheter system permit quick and reliable confirmation of the catheter location via echo or x-rays. Once across the septum the inner catheter is removed from the outer catheter and a standard intervention may be carried out through the lumen of the outer catheter.

A guidewire for performing a transseptal puncture, the guidewire having a distal end and a proximal end with an elongated length therebetween. The guidewire has at least one recess along its elongated length. The distal end of the guidewire is configured to puncture tissue. At least one guidewire marker is configured to be securely positioned, respectively at said at least one recess of the elongated length of the guidewire.

A transseptal needle or punch. The transseptal punch includes a stylet with a tube with a side window and a cutting wire disposed within the tube, with a sharp cutting segment disposed proximate the window. The sharp cutting segment can be expanded radially outwardly from the window by translation of the cutting wire proximal end within the tube.

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.

An example RF ablation system including a transseptal needle having an ablation electrode thereon can be used to perform a transseptal perforation using RF energy. Ablation energy can be applied and/or terminated based on a change in impedance at the ablation electrode when the electrode come into or out of contact with tissue. The transseptal needle can further include magnetic field sensors and one or more electrodes. The magnetic field sensors can be positioned approximate a distal end of the transseptal needle and can be configured to provide location information of the distal end.

A septostomy device 10 with a cutting structure or means 140 and tissue capture mechanisms 240, 250 is disclosed, along with a medical procedure for using the device. The system 10 is configured in such a way as to create a permanent interatrial aperture in the heart, including creating a permanent interatrial hole and/or removing tissue.

A medical device and a medical system that can reduce supply of energy to an energy transmission element without performing an operation of pressing the energy transmission element against a biological tissue. The medical device includes an expandable body, a shaft portion connected to the expandable body, an energy transmission element provided in the expandable body, a housing connected to a proximal end portion of the shaft portion, a displacement shaft that compresses the expandable body in an axial direction, an operation knob that is capable of moving with respect to the housing, a detection unit that is housed in the housing and that detects compression of the expandable body caused by the displacement shaft, an electric wire that is capable of being connected to an electric power supply device for supplying electric power to the energy transmission element, and that extends to the energy transmission element.