Transseptal access device and method of use
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.
1. A device for transseptal access, comprising:
a. an elongated member having a proximal end and a distal end, and a piercing element disposed at the distal end, the piercing element stationary with respect to the elongated member; and
b. a funnel coupled to the elongated member at the distal end, the funnel having a proximal end with a first radius and a distal end with a second radius, the second radius greater than the first radius, and a lip circumferentially surrounding the distal end with the second radius, the funnel having a retracted configuration and an expanded configuration, the expanded configuration defining an interior, the lip in the expanded configuration configured to be parallel to a septum through which access is desired, the funnel further defining pleats therein to impart a told during transition from the expanded configuration to the retracted configuration, and the funnel further including a rib or spine member formed of nitinol;
c. such that the elongated member, the piercing element, and the funnel are configured to be delivered to a septal location through a transseptal sheath, and such that upon removal of the funnel from the sheath, the funnel assumes the expanded configuration, and such that a pressure lumen is defined in the elongated member extending from the proximal end and into the interior of the funnel, the elongated member further comprising a lumen configured to draw negative pressure from the interior of the funnel to assist in a creation of a suction against the septum of the heart.
2. The device of claim 1 , wherein the first radius is between about 3 French to 10 French and the second radius is between about 2.5 mm and 15 mm.
3. The device of claim 2 , wherein the first radius is between about 5 French to 8 French and the second radius is between about 5 mm and 10 mm.
4. The device of claim 1 , further comprising a fitting attached to the pressure lumen at the proximal end of the elongated member, the fitting configured to attach a negative pressure source thereto.
5. The device of claim 4 , wherein the fitting is configured to attach a syringe thereto.
6. The device of claim 4 , wherein the negative pressure source is configured to draw a negative pressure of between about that drawn by a 5 cc syringe and that drawn by a 100 cc syringe.
7. The device of claim 6 , wherein the negative pressure source is configured to draw a negative pressure of between about that drawn by a 10 cc syringe and that drawn by a 20 cc syringe.
8. The device of claim 1 , wherein the rib or spine member is attached to the funnel.
9. The device of claim 1 , wherein the rib or spine member is not attached to the funnel.
10. The device of claim 1 , wherein the funnel has a straight shape or a convoluted shape.
11. The device of claim 1 , wherein the elongated member has further defined a guidewire lumen therein, the guidewire lumen extending from the proximal end and into the interior of the funnel.
12. The device of claim 1 , wherein in the retracted configuration, the funnel substantially surrounds the stationary piercing element.
13. The device of claim 1 , wherein in the expanded configuration, the funnel distal end extends further in a distal direction than does the piercing element.
14. The device of claim 1 , wherein the piercing element is a stationary needle coupled to the elongated member at the distal end.
15. The device of claim 1 , wherein the piercing element is a dilator with a sharp tip.
16. The device of claim 1 , wherein the funnel is formed from multiple segments.