Systems, devices, and methods for forming an anastomosis

Abstract

Disclosed herein are systems, devices, and methods for treating heart failure. In some variations, a catheter for forming an anastomosis in a heart may comprise a first catheter comprising an electrode. A second catheter may be slidably disposed within the first catheter. The second catheter may comprise a barb and a dilator comprising a mating surface configured to engage the electrode.

1 . A system for forming an anastomosis in a heart, comprising:
 a first catheter comprising an electrode; and   a second catheter slidably disposed within the first catheter, the second catheter comprising a barb and a dilator comprising a mating surface configured to engage the electrode.   
     
     
         2 . The system of  claim 1 , wherein the barb is disposed within a lumen of the electrode when the mating surface engages the electrode. 
     
     
         3 . The system of  claim 1 , wherein an outer diameter of the dilator is less than an outer diameter of the electrode. 
     
     
         4 . (canceled) 
     
     
         5 . The system of  claim 1 , wherein the second catheter defines a longitudinal axis, wherein the barb comprises at least one projection comprising a first portion and a second portion, the first portion angled relative to the second portion. 
     
     
         6 . The system of  claim 5 , wherein a length of the first portion to a length of the second portion is in a ratio between about 2:3 and about 1:5. 
     
     
         7 . The system of  claim 5 , wherein the second portion comprises a length between about 0.1 mm and about 2 cm. 
     
     
         8 .- 16 . (canceled) 
     
     
         17 . The system of  claim 1 , wherein a length of the barb is between about 0.1 mm and about 5 cm. 
     
     
         18 . The system of  claim 1 , wherein the electrode and the mating surface are configured to compress tissue therebetween. 
     
     
         19 . The system of  claim 1 , wherein the second catheter defines a longitudinal axis, and the mating surface is non-perpendicular and non-parallel to the longitudinal axis. 
     
     
         20 .- 31 . (canceled) 
     
     
         32 . The system of  claim 1 , wherein the dilator comprises a fluid port configured to output a contrast agent. 
     
     
         33 .- 34 . (canceled) 
     
     
         35 . The system of  claim 1 , wherein the first catheter comprises a contrast agent lumen. 
     
     
         36 .- 37 . (canceled) 
     
     
         38 . The system of  claim 1 , wherein the electrode comprises a fluid port configured to output a contrast agent. 
     
     
         39 .- 41 . (canceled) 
     
     
         42 . The system of  claim 1 , wherein the dilator comprises an echogenic region comprising one or more recesses or protrusions comprising a diameter of between about 5 μm and about 100 μm. 
     
     
         43 .- 48 . (canceled) 
     
     
         49 . The system of  claim 1 , further comprising a first catheter actuator configured to deflect a distal portion of the first catheter, the first catheter actuator electrically coupled to the electrode. 
     
     
         50 .- 53 . (canceled) 
     
     
         54 . The system of  claim 1 , wherein the mating surface defines a recess configured to receive a distal end of the electrode. 
     
     
         55 . The system of  claim 54 , wherein the electrode is configured to electrically short when the electrode engages the recess of the mating surface. 
     
     
         56 .- 58 . (canceled) 
     
     
         59 . The system of  claim 1 , wherein the mating surface comprises a conductive portion. 
     
     
         60 . The system of  claim 1 , wherein a proximal portion of the dilator is arranged within a lumen of the electrode when the mating surface engages the electrode. 
     
     
         61 .- 97 . (canceled) 
     
     
         98 . A system for forming an anastomosis in a heart, comprising:
 a first catheter comprising an electrode; and   a second catheter slidably disposed within the first catheter, the second catheter comprising a barb and a dilator, wherein a proximal portion of the dilator comprises a first step portion comprising a first diameter and a second step portion comprising a second diameter greater than the first diameter, the first step portion proximal to the second step portion.   
     
     
         99 . A system for forming an anastomosis in a heart, comprising:
 a first catheter comprising an electrode; and   a second catheter slidably disposed within the first catheter, the second catheter comprising a barb and a dilator, wherein the barb is enclosed within a lumen of the electrode when the dilator engages the electrode.   
     
     
         100 .- 103 . (canceled)