Medical sheath and related systems and methods

1. A transseptal perforation system comprising:

a perforation device; and

a medical sheath comprising:

an elongate member having a proximal portion defining a proximal end and a distal portion defining a distal end, and a first lumen extending through the elongate member and open at the proximal and the distal end for passage of the perforation device through the lumen; and

an anchoring mechanism that is deployable from the elongate member and comprises an anchor that is removably securable to an anatomical feature to secure the elongate member to the anatomical feature for facilitating positioning of the sheath and providing stability to the perforation device for perforating a tissue, and a connector for securing the anchor to the elongate member;

wherein the anchor is an expandable structure movable between a lock configuration for securing to the anatomical feature and a release configuration for releasing the anatomical feature;

wherein the expandable structure is expanded when the anchor is in the lock configuration and is retracted when the anchor is in the release configuration; and wherein the anchoring mechanism further comprises a perforating tip for perforating the anatomical feature.

2. The system of claim 1 , further comprising a second lumen extending through the elongate member and open at the distal portion, wherein the anchor is movable between a storage position in which the anchor is housed within the second lumen and a deployed position in which the anchor is outside of the second lumen.

3. The system of claim 2 , further comprising a first actuator actuatable to move the anchor between the storage position and the deployed position.

4. The system of claim 2 , wherein when in the deployed position, the anchor is spaced radially from the elongate member.

5. The system of claim 1 , further comprising a handle secured to the proximal portion of the elongate member, wherein the connector comprises a wire secured at a first end to the handle and at a second end to the anchor.

6. A transseptal perforation system, comprising

a sheath comprising i) an elongate member having a proximal portion defining a proximal end and an opposed distal portion defining a distal end, and a first lumen extending through the elongate member and open at the proximal end and the distal end, and ii) an anchoring mechanism that is deployable from the elongate member and comprises an anchor that is removably securable to an anatomical feature to secure the elongate member to the anatomical feature for facilitating positioning of the sheath, and a connector for securing the anchor to the elongate member, wherein the anchor is a clamp for clamping onto the anatomical feature, the clamp movable between a locked configuration wherein the clamp is closed for securing to the anatomical feature and a release configuration wherein the clamp is open for releasing the anatomical feature;

a dilator advanceable through the lumen from the proximal end to the distal end and having a dilating tip; and

a perforation device advanceable through the dilator towards the dilating tip and having a perforating tip, wherein the anchor provides stability to the perforation device when the anchor is removably secured to an anatomical feature.

7. A transseptal perforation system comprising:

a perforation device; and

a medical sheath comprising:

an elongate member having a proximal portion defining a proximal end and a distal portion defining a distal end, a first lumen extending through the elongate member and open at the proximal and the distal end for passage of the perforation device through the lumen, and a second lumen extending through the elongate member and open at the distal portion;

an anchor configured to be movable from a storage position in the second lumen and a deployed position outside the second lumen, the anchor further configured to be movable between a lock configuration for securing to an anatomical feature for facilitating positioning of the sheath and a release configuration;

a first actuator configured to move the anchor between the storage position and the deployed position; and

a second actuator actuatable to move the anchor between the lock configuration and the release configuration.

8. The system of claim 7 , wherein when in the deployed position, the anchor is spaced radially from the elongate member.

9. The system of claim 7 , wherein the anchor comprises a clamp for clamping onto the anatomical feature, and wherein in the lock configuration the clamp is closed and in the release configuration the clamp is open.

10. The system of claim 7 , wherein the anchor comprises a perforating tip for perforating the anatomical feature.

11. The system of claim 7 further comprising a handle secured to the proximal portion of the elongate member.