Abstract: An elongated guidewire assembly has a distal segment configured to be selectively maneuvered, along an elongated Introducer assembly. The distal segment is configured to selectively transmit a tenting force from the elongated guidewire assembly to the first biological wall after the distal segment has contacted, at least in part, the first biological wall and the distal segment has been selectively protracted away from the distal introducer assembly.

Abstract: A lock for positioning a first medical device with respect to a second medical device includes a spacer for preventing advancement of the first medical device towards the second medical device. The spacer is movable between a lock position and an unlock position. In the lock position, the spacer is moved transverse to the longitudinal axis with respect to the unlock position. The lock further includes a rotary stop integral with the spacer for fixing the rotational position of the first medical device with respect to the second medical device. The lock further includes a clip integral with the spacer and removably securable to the first medical device in a first position to secure the spacer in the unlock position, and removably securable to the first medical device in a second position to secure the spacer in the lock position.

Abstract: A method for carrying out a medical procedure includes advancing a medical device towards a puncture site in a patient's body and positioning a radiofrequency puncture electrode of the medical device adjacent the puncture site; delivering radiofrequency energy from the radiofrequency puncture electrode to create a puncture in the puncture site; advancing the medical device through the puncture to position an auxiliary electrode of the medical device adjacent a target site in the patient's body; and using the auxiliary electrode for diagnosis, mapping, and/or treatment at the target site.

Abstract: Medical devices are disclosed having improved visualization of a portion of the medical device insertable into a patient's body while minimizing obstruction of fluid flow through a lumen of the device and while minimizing an increase in the outer diameter of the device attributable to the feature providing improved visualization. The device can include, for example, an imaging marker distal to lumen openings (exit ports), or, where the device comprises a tube, such as a metallic tube, an imaging marker embedded into a wall of the tube. Another embodiment includes attaching a marker to the surface on the inside of a lumen of a medical device without embedding the marker. Various alternative embodiments, methods and applications of using such devices are disclosed as well.

Abstract: An electrosurgical device for puncturing tissue comprises an electrically conductive elongate member which is capable of force transmission from a distal portion of the electrosurgical device to a proximal portion of the electrosurgical device to thereby provide tactile feedback to a user. The proximal portion comprises a connector system for connecting a source of energy and a source of fluid to an electrosurgical device. The connector system includes a hub which includes an electrically conductive lengthwise member having a lengthwise member distal region and a lengthwise member proximal region. The lengthwise member defines a hub lumen therebetween and is configured to be operatively coupled to an electrosurgical device.

Abstract: A puncturing device configured to create a puncture in a tissue comprising an elongate member comprising a proximal portion defining a longitudinal axis along the length of the elongate member. The elongate member further comprises a flexible distal portion of the that curves away from the longitudinal axis and a distal tip configured to deliver energy to the tissue. A sensing element placed on the flexible distal portion of the elongate member detects the curvature of the distal portion such that when the flexible distal portion of the elongate member is straightened, energy is delivered to the distal tip and when the flexible distal portion of the elongate member is curved, energy is not delivered to the distal tip.

Abstract: A system of medical devices includes a first medical device, a second medical device, an RLC circuit, a processor, and an output device. The first medical device includes an elongate member having a lumen. The second medical device includes a needle advanceable through the lumen. The RLC circuit includes an excitation voltage source, a resistor, a capacitor, an inductor, and an output voltage sensor. The inductor includes a coil that is supported by the first medical device and wound around the lumen. As the needle is advanced through the lumen, an output voltage of the RLC circuit is an indicator of a longitudinal position of the needle with respect to the elongate member. The voltage sensor is configured to sense the output voltage, and the processor and output device are configured to generate an output that is an indicator of the longitudinal position of the needle.

Abstract: Apparatuses and methods are disclosed for the perforation of a communication between the aorta and left atrium. The method includes introducing the apparatus, positioning the apparatus at a location along the aorta, and energizing the apparatus to create a perforation. For example, one method may include: introducing a flexible wire into the left atrium, advancing a dilator along the flexible wire to position the flexible wire adjacent a selected location along the aorta and energizing the flexible wire to create a perforation from the left atrium into the aorta.

Abstract: Apparatuses and methods are disclosed for the perforation of a communication between the aorta and left atrium. The method includes introducing the apparatus, positioning the apparatus at a location along the aorta, and energizing the apparatus to create a perforation. For example, one method may include: introducing a flexible wire into the left atrium, advancing a dilator along the flexible wire to position the flexible wire adjacent a selected location along the aorta and energizing the flexible wire to create a perforation from the left atrium into the aorta.

Abstract: A steerable catheter control handle and method are provided for bi-directional control of a steerable catheter, the catheter including at least two control wires, a distal end of each of the control wires being coupled to the catheter at a distal region thereof. The control system comprises a housing. A wire actuation mechanism is disposed within the housing and is operably coupled to at least two control wires for enabling actuation of the at least two control wires. The steerable catheter control handle additionally comprises a proximal control knob that is operably coupled to the wire actuation mechanism to enable actuation of the at least two control wires for causing a distal end deflection of the steerable catheter.

Abstract: Medical devices are disclosed having improved visualization of a portion of the medical device insertable into a patient's body while minimizing obstruction of fluid flow through a lumen of the device and while minimizing an increase in the outer diameter of the device attributable to the feature providing improved visualization. The device can include, for example, an imaging marker distal to lumen openings (exit ports), or, where the device comprises a tube, such as a metallic tube, an imaging marker embedded into a wall of the tube. Another embodiment includes attaching a marker to the surface on the inside of a lumen of a medical device without embedding the marker. Various alternative embodiments, methods and applications of using such devices are disclosed as well.

Abstract: A laceration device for use in medical procedures includes a shaft having opposed proximal and distal portions. A clamp extends from the distal portion. The clamp has first and second clamp arms. The clamp is movable between an open and closed positions. In the open position, the first clamp arm is spaced apart from the second clamp arm. In the closed position, the first clamp arm is moved towards the second clamp arm. A clamp actuator is connected to the clamp via the shaft and is manipulatable to move the clamp between the open and closed positions. A radiofrequency electrode (RF) is associated with the first clamp arm. The RF electrode has a first perforation surface that is positioned to face the second clamp arm when the clamp is in the closed position. An electrical connector extends proximally from the RF electrode for connection to a power source.

Abstract: An elongated support assembly is positionable, at least in part, in sliding relationship with an elongated flexible medical assembly. The elongated support assembly is configured to support, at least in part, the elongated flexible medical assembly after the elongated support assembly is positioned, at least in part, in sliding relationship with the elongated flexible medical assembly. The elongated support assembly is, at least in part, selectively maneuverable via an elongated ancillary medical assembly toward a distal portion of the elongated ancillary medical assembly.

Abstract: A method and apparatus are disclosed for a device for creating a puncture in a tissue. The puncturing device comprising an elongate member having a puncturing portion at the distal tip. The puncturing device further includes at least one inflatable feature positioned around the outer circumference and at a distal portion of the elongate member. The puncturing device includes a lumen extending from a proximal end of the elongate member to the inflatable feature. The inflatable feature is in a fluid communication with the lumen and can be inflated to dilate the puncture in the tissue or anchor the puncturing device in a heart structure.

Abstract: A catheter includes an elongate shaft extending longitudinally between a proximal portion defining a proximal end and a distal portion defining a distal end. A lumen extends through the shaft from the proximal end to the distal end. The shaft includes a heat-shielding layer and an outer layer adjacent the heat-shielding layer. The heat-shielding layer includes an inner liner layer adjacent the lumen and a heat-shielding layer adjacent the inner liner layer. In the distal portion, at least a section of the outer layer is radiopaque.

Abstract: An electrosurgical device for puncturing tissue comprises an electrically conductive elongate member which is capable of force transmission from a distal portion of the electrosurgical device to a proximal portion of the electrosurgical device to thereby provide tactile feedback to a user. The proximal portion comprises a handle or hub which includes an electrical connector configured to receive, in a releasable manner, an electrically conductive component operable to be electrically coupled to an energy source.

Abstract: A laceration device for use in medical procedures includes a shaft having a proximal portion defining a proximal end, and an opposed distal portion defining a distal end. A perforation electrode is at the distal end, and a first electrical connector extends proximally from the perforation electrode for connection to a power source. An outwardly extending barb is positioned proximal of the distal end. The barb has an inner end proximate the shaft and an outer end opposite the inner end. A laceration electrode is proximal of and adjacent the inner end of the barb, and a second electrical connector extends proximally from the laceration electrode for connection to the power source.

Abstract: An apparatus is for an elongated sheath assembly configured to receive, at least in part, an elongated dilator assembly. The apparatus includes a dilator-receiver device configured to be installed to the elongated sheath assembly. A dilator-receiver mover is configured to be mounted, at least in part, to the elongated sheath assembly. The dilator-receiver mover is configured to be operatively connected to the dilator-receiver device. The dilator-receiver mover is also configured to selectively move the dilator-receiver device along a predetermined distance.

Abstract: An electrosurgical device for puncturing tissue comprises an electrically conductive elongate member which is capable of force transmission from a distal portion of the electrosurgical device to a proximal portion of the electrosurgical device to thereby provide tactile feedback to a user. The proximal portion comprises a handle or hub which includes an electrical connector configured to receive, in a releasable manner, an electrically conductive component operable to be electrically coupled to an energy source.

Abstract: A method and apparatus are disclosed for an optimized transseptal procedure for providing left heart access, that reduces the number of devices that are used in order to minimize procedural time, complexity and cost. The apparatus comprises a reshapeable hybrid dilator that comprises the combined functionality of a transseptal sheath and dilator assembly. The hybrid dilator comprises: a dilator shaft defining a lumen for receiving a crossing device therethrough, the dilator shaft comprising a stiffening member and a deflectable portion, being structured to provide support for the crossing device when the crossing device is used to create a puncture in a tissue; and a distal tip having an outer diameter which tapers down to an outer diameter of the crossing device for providing a smooth transition between the crossing device and the distal tip when the crossing device is inserted through the lumen and protrudes beyond the distal tip.