Transseptal delivery instrument

Abstract

Access to the left side of the heart is gained through a heart wall. A delivery instrument includes a guide that may include or carry a puncturing instrument that is adapted to be directed toward the heart wall. In some embodiments a distal portion of the delivery instrument may be adapted to be co-located with the coronary sinus. In addition, the guide may be located a known distance from the portion of the delivery instrument that is co-located with the coronary sinus. Access to the left side of the heart may thus be readily gained by positioning the delivery instrument relative to the coronary sinus.

1 . An apparatus for accessing a left side of a heart of a patient, comprising:
 an elongated structural member, adapted to be routed to the heart via a superior transvenous approach, comprising a seating structure on a distal portion of the structural member, the seating structure adapted to engage tissue adjacent to the ostium of the coronary sinus of the heart;   a guide, coupled with the structural member, and adapted to carry a piercing instrument and adapted to reorient at a distal portion to direct the piercing instrument toward an inter-atrial septum of the heart; and   a sliding member, coupled with the guide, and adapted to be controlled at a proximal end to reorient the distal portion of the guide.   
     
     
         2 . The apparatus of  claim 1  wherein the seating structure extends from the structural member at an angle with respect to a longitudinal axis of the structural member. 
     
     
         3 . The apparatus of  claim 1  wherein the seating structure is adapted to expand from the structural member. 
     
     
         5 . The apparatus of  claim 1  wherein the seating structure comprises a plurality of tines.