US 11,986,202 B2
Steerable endoluminal punch with introducer and guidewire
Jay Alan Lenker, Lake Forest, CA (US); James Alexander Carroll, Long Beach, CA (US); Eugene Michael Breznock, Winters, CA (US); Donald J. Kolehmainen, Laguna Niguel, CA (US); and Peter van der Sluis, Scottsdale, AZ (US)
Assigned to Indian Wells Medical, Inc., Lake Forest, CA (US)
Filed by Indian Wells Medical, Inc., Lake Forest, CA (US)
Filed on May 9, 2023, as Appl. No. 18/314,462.
Application 18/314,462 is a continuation of application No. 17/878,552, filed on Aug. 1, 2022, granted, now 11,648,025.
Claims priority of provisional application 63/340,846, filed on May 11, 2022.
Claims priority of provisional application 63/329,302, filed on Apr. 8, 2022.
Claims priority of provisional application 63/227,835, filed on Jul. 30, 2021.
Prior Publication US 2023/0277208 A1, Sep. 7, 2023
Int. Cl. A61B 17/32 (2006.01); A61B 17/00 (2006.01); A61B 17/3205 (2006.01)
CPC A61B 17/320016 (2013.01) [A61B 17/32053 (2013.01); A61B 2017/00247 (2013.01); A61B 2017/320052 (2013.01)] 3 Claims
OG exemplary drawing
 
1. A method of crossing the interatrial septum of a patient's heart, to gain access to the left atrium through the right atrium, in which a steerable endoluminal punch is advanced over a guidewire, said method comprising the steps of:
inserting the guidewire into vasculature of the patient to locate the distal tip of the guidewire in the superior vena cava;
advancing the steerable endoluminal punch over the guidewire to locate the distal end of the steerable endoluminal punch in the right atrium, such that the distal tip of the guidewire is disposed within the distal tip of the steerable endoluminal punch, and both reside in the right atrium;
operating the steerable endoluminal punch to steer the distal end of the punch to place the distal end of the punch against the interatrial septum;
pressing the punch and guidewire distal tips against the interatrial septum to tent the interatrial septum;
advancing the distal tip of the punch and guidewire distally until a sharp distal tip of the punch perforates the interatrial septum;
delivering a large bore introducer sheath and a dilator over the steerable endoluminal punch, to locate a distal end of the large bore introducer sheath in the left atrium;
without exchanging the large bore introducer sheath for a different introducer sheath, with the guidewire remaining in place, removing the steerable endoluminal punch and delivering a device delivery catheter, diagnostic catheter, or therapeutic catheter through the large bore introducer sheath and into the left atrium.