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 stationary piercing element disposed at the distal end; 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, the funnel having a retracted configuration and an expanded configuration, the expanded configuration defining an interior;
c. such that the elongated member, the piercing element, and the funnel are configured to be delivered to a septal location through a 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 disposed in the elongated member extending from the proximal end and into the interior of the funnel;
d. wherein in the expanded configuration, and prior to a negative pressure being applied to the pressure lumen, the funnel distal end extends further in a distal direction than does the stationary piercing element, and such that the elongated member, the stationary piercing element, and the funnel are configured such that when the funnel is in the expanded configuration and placed against a septum, and a negative pressure is applied to the pressure lumen, the septum is pulled across the stationary piercing element, wherein the septum is punctured, and transseptal access is accomplished.
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 or micropump_thereto.
6. The device of claim 1 , wherein the funnel further comprises a lip formed at the distal end.
7. 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.
8. The device of claim 7 , 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.
9. The device of claim 1 , wherein the funnel further comprises a rib, a spine member, or a pleat.
10. The device of claim 9 , wherein the funnel is formed of a shape memory material or is formed of a polymer, and the rib or spine member is comprised of a shape memory metal.
11. The device of claim 9 , wherein the spine member is attached to the funnel.
12. The device of claim 1 , wherein the funnel has a straight shape or a convoluted shape.
13. 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.
14. The device of claim 1 , wherein in the retracted configuration, the funnel substantially surrounds the stationary piercing element.
15. The device of claim 1 , wherein the funnel distal end includes a radio-opaque feature.
16. The device of claim 1 , wherein the piercing element is hollow.
17. The device of claim 1 , wherein the piercing element includes a dilator.