Abstract: A method is provided for accessing a pericardial space of a subject. The method includes advancing a guide member toward a heart, having (a) a transparent blunt distal end, and (b) a side-facing suction port. During advancing of the guide member, an imaging device disposed in the guide member generates an image of part of the heart. Subsequently to contacting the pericardium with the suction port, the imaging device is retracted proximally in the guide member. Subsequently, a portion of the pericardium is drawn into the guide member through the suction port. Following the drawing of the portion into the guide member, an image of the pericardium disposed within the suction port, is generated. Subsequently, a puncturing element is advanced in the guide member to puncture the portion of the pericardium that is in the guide member. Other applications are also described.

Abstract: Apparatus (610) for closure of a left atrial appendage (220) of a heart, comprising a deployment device (520) configured to enter a pericardial region of the heart and to be advanced toward an outer surface of the left atrial appendage; and first and second rigid longitudinal rod elements (630) coupled to each other by at least one coupling suture (552), the first and second rigid longitudinal rod elements (630) being deployable by the deployment device on opposing external surfaces of the left atrial appendage, and configured to compress tissue of the left atrial appendage due to pulling of at least one proximal portion of the coupling suture (552). Other applications are also described.

Abstract: A method is provided for accessing a pericardial space of a subject. The method includes advancing a guide member toward a heart, having (a) a transparent blunt distal end, and (b) a side-facing suction port. During advancing of the guide member, an imaging device disposed in the guide member generates an image of part of the heart. Subsequently to contacting the pericardium with the suction port, the imaging device is retracted proximally in the guide member. Subsequently, a portion of the pericardium is drawn into the guide member through the suction port. Following the drawing of the portion into the guide member, an image of the pericardium disposed within the suction port, is generated. Subsequently, a puncturing element is advanced in the guide member to puncture the portion of the pericardium that is in the guide member. Other applications are also described.

Abstract: Apparatus (120) is provided comprising: a longitudinal guide member (220) (a) comprising a blunt distal end (160) having an outer surface (164) at least part of which is transparent, (b) configured to be advanced distally toward a heart of a subject, and (c) shaped to define an at least partially distally-facing and side-facing suction port (660) at a distal portion (662) of the longitudinal guide member (220). The apparatus is configured to facilitate drawing a portion of a pericardium of the heart through the suction port and into the longitudinal guide member. The apparatus additionally comprises a puncturing element (50) configured to puncture the portion of the pericardium while the portion of the pericardium is in the longitudinal guide member. Other applications are also described.

Abstract: Apparatus and methods are described, including apparatus comprising a longitudinal guide member comprising a blunt distal end having an outer surface at least part of which is transparent. The guide member is advanced distally toward a heart of a subject. A sheath is shaped and sized to surround the guide member and shaped to define an at least partially distally-facing suction port at a distal end of the sheath. A portion of a pericardium of the heart is drawn through the suction port and into the sheath, when the suction port is distal to the guide member. A puncturing element punctures the portion of the pericardium while the portion of the pericardium is in the sheath, and a puncturing-element-restraining element inhibits passage of a distal tip of the puncturing element out of the distal end of the sheath. Other applications are also described.