Abstract: In some embodiments, an apparatus includes a sheath defining a lumen and a catheter slidably disposable within the lumen of the sheath and configured to extend distally relative to the sheath. The apparatus includes a dilator slidably disposable within a lumen of the catheter and configured to extend distally relative to the catheter and the sheath. A distal end portion of the sheath has an inner diameter that is less than a maximum outer diameter of the dilator when a portion of the dilator having the maximum outer diameter is disposed proximal to or distal to the distal end portion of the sheath. The apparatus further includes a radiofrequency (RF) guidewire slidably disposable within a lumen of the dilator and configured to extend distally relative to the dilator, the RF guidewire configured deliver energy to a target perforation site of a patient.

Abstract: Methods and devices for transvascular prosthetic chordae tendinea implantation are disclosed. A catheter is advanced into the left atrium. From an atrium side, the catheter can be anchored to a superior surface of a mitral valve leaflet and a leaflet anchor can be advanced into the mitral valve leaflet to secure the mitral valve leaflet to a leaflet suture. A ventricular anchor is anchored to the wall of the ventricle to secure the ventricular wall to a ventricle suture. The leaflet suture and the ventricle suture may be tensioned and connected by a suture lock to form an artificial chordae.