Fossa ovalis puncturing catheter
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.
1. Apparatus for puncturing a fossa ovalis, the apparatus comprising:
a catheter, which (a) 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, and (b) is shaped so as to define a central catheter lumen open through the catheter distal end opening:
a flexible longitudinal member that passes (a) from a proximal portion of the catheter to the distal portion of the catheter, (b) out of the first lateral opening, and (c) into the second lateral opening, so as to form a loop outside the catheter: and
wherein the flexible longitudinal member is configured to assume an unconstrained delivery configuration in which a distal-most portion of the loop is curved and contacts an external surface of the catheter at a contact location distal to the first and the second lateral openings: and
a puncturing element, which 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.
2. The apparatus according to claim 1 , wherein the apparatus is configured to form exactly one loop that passes out of the distal portion of the catheter.
3. The apparatus according to claim 1 , wherein the apparatus further comprises a dilator, which (a) is slidably disposed within the central catheter lumen, and (b) comprises:
a dilator body, which is shaped so as to define a dilator lumen; and
a dilator tip, which is (i) disposed at a distal end of the dilator, (ii) shaped so as to define a dilator-tip distal end opening through which the dilator lumen is open, and (iii) configured to dilate the hole in the fossa ovalis punctured by the puncturing element.
4. The apparatus according to claim 3 , wherein the puncturing element is slidably disposed within the dilator lumen, and is configured to puncture the hole in the fossa ovalis by being advanced out of the dilator-tip distal end opening and through the fossa ovalis.
5. The apparatus according to claim 1 , wherein the puncturing element comprises a wire, which extends from the proximal portion of the catheter to the distal portion of the catheter, and which is shaped so as to define a distal tip of the puncturing element.
6. The apparatus according to claim 1 , wherein the flexible longitudinal member comprises a wire.
7. The apparatus according to claim 1 ,
wherein a wall of the catheter is shaped so as to define a longitudinally-running lumen in the wall, and
wherein a portion of the flexible longitudinal member passes (a) from the proximal portion of the catheter to the distal portion of the catheter via the longitudinally-running lumen, and (b) out of the first lateral opening from the longitudinally-running channel.
8. The apparatus according to claim 7 ,
wherein the longitudinally-running lumen is a first longitudinally-running lumen,
wherein the wall of the catheter is shaped so as to define a second longitudinally-running lumen in the wall, and
wherein the flexible longitudinal member passes (a) from the proximal portion of the catheter to the distal portion of the catheter via the first longitudinally-running lumen, (b) out of the first longitudinally-running lumen via the first lateral opening, (c) into the second channel via the second lateral opening, and (d) from the distal portion of the catheter to the proximal portion of the catheter via the second longitudinally-running lumen, so as to form the loop outside the catheter.
9. The apparatus according to claim 7 , wherein an internal diameter of the central catheter lumen is greater than an internal diameter of the longitudinal-running lumen in the wall.
10. The apparatus according to claim 1 , wherein the first and the second lateral openings are at a same distance from the distal end of the catheter.
11. The apparatus according to claim 1 , wherein the first and the second lateral openings are disposed at a distance that is 1-5 cm from the distal end of the catheter.
12. The apparatus according to claim 1 , wherein the first and the second lateral openings are disposed at a distance that is no more than 1 cm from the distal end of the catheter.
13. The apparatus according to claim 1 , wherein a distance of the first lateral opening from the distal end of the catheter differs by less than 1 cm from a distance of the second lateral opening from the distal end of the catheter.
14. The apparatus according to claim 1 , wherein the flexible longitudinal member is radiopaque.