Abstract: A method is provided for measuring an opening of an appendage of an atrium of a subject, the method including inserting a catheter into the atrium of the subject using a transvenous approach. Thereafter, at least one loop is deployed from a wall of the catheter, such that a distal end of the loop is distal to a distal end of the catheter. Thereafter, the loop is used to measure the opening of the appendage. Other embodiments are also described.

Abstract: 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.

Abstract: Apparatus for puncturing a fossa ovalis includes a catheter shaped so as to define a central catheter lumen open through a catheter distal end opening. An angle between (i) a first line running between first and second lateral openings defined by the catheter and (ii) a second line that is parallel to a central longitudinal axis of the catheter when the catheter is straight, is between 30 and 150 degrees. A flexible longitudinal member passes (a) from a proximal portion of the catheter to a 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. The flexible longitudinal member is configured to assume a deployment configuration in which a distal-most portion of the loop is curved and is distal to the catheter distal end opening. Other embodiments are also described.

Abstract: A method is provided including inserting a catheter into a right atrium and advancing a distal portion of the catheter toward a roof of the right atrium. A flexible longitudinal member is deployed from the catheter, such that a deployed portion of the flexible longitudinal member is loop-shaped. The deployed portion of the flexible longitudinal member is brought into contact with a single stabilization site located on the roof of the right atrium, between the roof and an interatrial septum, or on the interatrial septum superior to a fossa ovalis. A needle is deployed from the catheter and brought in contact with a hole site on a surface of the interatrial septum outside the fossa ovalis. A hole is formed through the interatrial septum at the hole site with the needle. The deployed portion of the flexible longitudinal member is withdrawn toward the catheter. Other embodiments are also described.

Abstract: A method is provided, including inserting a catheter into a right atrium of a heart of the subject. A distal portion of the catheter is advanced toward a fossa ovalis of the heart. A flexible longitudinal member is deployed from the catheter, such that a deployed portion of the flexible longitudinal member is loop-shaped. The fossa ovalis is contacted with the deployed portion of the flexible longitudinal member. A needle is deployed from the catheter. A distal end of the needle is brought in contact with a site on a surface of an interatrial septum of the heart outside the fossa ovalis. A hole is formed through the interatrial septum at the site with the needle. The deployed portion of the flexible longitudinal member is withdrawn toward the catheter.

Abstract: A wall of a catheter (a) includes a braided portion having an outer surface, an inner surface, and a braided interior between the outer and inner surfaces, and (b) is shaped to define first and second longitudinally-running channels therethrough. A distal portion of the catheter is shaped to define first and second lateral openings. An angle between (a) a first line running between the first and second lateral openings, and (b) a second line that is parallel to a central longitudinal axis of the catheter when the catheter is straight, is between 30 and 150 degrees. A flexible longitudinal member passes from a proximal portion of the catheter to the distal portion via the first channel, out of the first channel via the first lateral opening, into the second channel via the second lateral opening, and from the distal portion to the proximal portion via the second channel.

Abstract: Apparatus is provided for puncturing a fossa ovalis of a heart, the apparatus including a catheter shaped to define a catheter lumen, and a puncturing element slidably disposed within the catheter lumen. The puncturing element is configured to be deployed from a distal portion of the catheter and to puncture the fossa ovalis. The apparatus is shaped to define one or more orifices configured to facilitate positioning of the puncturing element by directing a flow from the apparatus of one or more streams of a contrast agent at an angle of at least 10 degrees with respect to a distally-pointing vector that is parallel to a longitudinal axis of the catheter at the one or more orifices. Other embodiments are also described.

Abstract: A wall (39) of a catheter (38) (a) includes a braided portion (41) having an outer surface (45), an inner surface (47), and a braided interior (53) between the outer and inner surfaces (45, 47), and (b) is shaped to define first and second longitudinally-running channels (27a, 27b) therethrough. A distal portion of the catheter (38) is shaped to define first and second lateral openings (26a, 26b). An angle between (a) a first line (76) running between the first and second lateral openings (26a, 26b), and (b) a second line (78) that is parallel to a central longitudinal axis of the catheter (38) when the catheter (38) is straight, is between 30 and 150 degrees.

Abstract: A method is provided for puncturing a fossa ovalis of a heart, the method including inserting a catheter into a right atrium of the heart, and advancing a distal portion of the catheter toward an interatrial septum of the heart. A flexible longitudinal member is slid through openings disposed at the distal portion of the catheter, such that the flexible longitudinal member is made to loop around a portion of an inside perimeter of the fossa ovalis. While the flexible longitudinal member is looped around the portion of the inside perimeter of the fossa ovalis, a hole is punctured in the fossa ovalis at a puncturing point.

Abstract: A wall (39) of a catheter (38) (a) includes a braided portion (41) having an outer surface (45), an inner surface (47), and a braided interior (53) between the outer and inner surfaces (45, 47), and (b) is shaped to define first and second longitudinally-running channels (27a, 27b) therethrough. A distal portion of the catheter (38) is shaped to define first and second lateral openings (26a, 26b). An angle between (a) a first line (76) running between the first and second lateral openings (26a, 26b), and (b) a second line (78) that is parallel to a central longitudinal axis of the catheter (38) when the catheter (38) is straight, is between 30 and 150 degrees.

Abstract: A method is provided for measuring an opening of an appendage of an atrium of a subject, the method including inserting a catheter into the atrium of the subject using a transvenous approach. Thereafter, at least one loop is deployed from a wall of the catheter, such that a distal end of the loop is distal to a distal end of the catheter. Thereafter, the loop is used to measure the opening of the appendage. Other embodiments are also described.

Abstract: A method is provided for measuring an opening of an appendage of an atrium of a subject, the method including inserting a catheter into the atrium of the subject. At least one loop is deployed from a wall of the catheter, such that a distal end of the loop is distal to a distal end of the catheter. The loop is used to measure the opening of the appendage.

Abstract: A method is provided for puncturing a fossa ovalis of a heart, the method including inserting a catheter into a right atrium of the heart, and advancing a distal portion of the catheter toward an interatrial septum of the heart. A flexible longitudinal member is slid through openings disposed at the distal portion of the catheter, such that the flexible longitudinal member is made to loop around a portion of an inside perimeter of the fossa ovalis. While the flexible longitudinal member is looped around the portion of the inside perimeter of the fossa ovalis, a hole is punctured in the fossa ovalis at a puncturing point.

Abstract: A method is provided, including inserting a catheter into a right atrium of a heart of the subject. A distal portion of the catheter is advanced toward a fossa ovalis of the heart. A flexible longitudinal member is deployed from the catheter, such that a deployed portion of the flexible longitudinal member is loop-shaped. The fossa ovalis is contacted with the deployed portion of the flexible longitudinal member. A needle is deployed from the catheter. A distal end of the needle is brought in contact with a site on a surface of an interatrial septum of the heart outside the fossa ovalis. A hole is formed through the interatrial septum at the site with the needle. The deployed portion of the flexible longitudinal member is withdrawn toward the catheter.

Abstract: A wall (39) of a catheter (38) (a) includes a braided portion (41) having an outer surface (45), an inner surface (47), and a braided interior (53) between the outer and inner surfaces (45, 47), and (b) is shaped to define first and second longitudinally-running channels (27a, 27b) therethrough. A distal portion of the catheter (38) is shaped to define first and second lateral openings (26a, 26b). An angle between (a) a first line (76) running between the first and second lateral openings (26a, 26b), and (b) a second line (78) that is parallel to a central longitudinal axis of the catheter (38) when the catheter (38) is straight, is between 30 and 150 degrees.

Abstract: Apparatus and methods are described, including apparatus for puncturing a fossa ovalis of a heart. The apparatus includes a catheter shaped to define a catheter lumen. A puncturing element is slidably disposed within the catheter lumen, and is deployed from a distal portion of the catheter and to puncture the fossa ovalis. A probing element is deployed from the distal portion of the catheter. Upon being deployed, the probing element probes tissue near the fossa ovalis, the probing element having a first configuration thereof upon probing the tissue near the fossa ovalis. Upon probing tissue of the fossa ovalis, the probing element facilitates positioning of the puncturing element, by automatically adopting a second configuration thereof that is different from the first configuration. Other applications are also described.

Abstract: A method is provided for measuring an opening of an appendage of an atrium of a subject, the method including inserting a catheter into the atrium of the subject. At least one loop is deployed from a wall of the catheter, such that a distal end of the loop is distal to a distal end of the catheter. The loop is used to measure the opening of the appendage.

Abstract: A method is provided that includes inserting a catheter into an atrium of a subject, and deploying at least one loop from a wall of the catheter, such that a distal end of the loop is distal to a distal end of the catheter. The method further includes inserting the loop partially into an appendage of the atrium, and, while inserting the loop, atraumatically contacting a portion of a perimeter of an opening of the appendage with a portion of the loop. Thereafter, the loop is further inserted into the appendage. Thereafter, a size of the opening of the appendage is measured using the loop. Other applications are also described.

Abstract: Apparatus and methods are described, including apparatus for puncturing a fossa ovalis of a heart. The apparatus comprises a catheter shaped to define a catheter lumen. A puncturing element is slidably disposed within the catheter lumen, and is configured to be deployed from a distal portion of the catheter and to puncture the fossa ovalis. One or more flexible longitudinal members are configured to be deployed from the distal portion of the catheter, and upon being deployed, facilitate the puncturing of the fossa ovalis by the puncturing element, by contacting tissue at a perimeter of the fossa ovalis. Other applications are also described.

Abstract: Apparatus and methods are described, including a method for measuring an opening of an appendage of an atrium of a subject. A catheter is inserted into the atrium, and at least one loop is deployed from a wall of the catheter, such that a distal end of the loop is distal to a distal end of the catheter. The loop is used to measure the opening of the appendage. Other applications are also described.