| CPC A61F 2/243 (2013.01) | 20 Claims |

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1. A method for percutaneous antegrade access of a heart, the method comprising:
advancing a first inner catheter that is distally tapered into a left atrium through a transseptal puncture, wherein a distal region of the inner catheter is flush with an outer catheter at a distal end region of the outer catheter;
expanding an expandable deflector to deflect away from the chordae tendinae of the left ventricle;
advancing the outer catheter and either the first inner catheter or a second inner catheter that has been exchanged for the first inner catheter, so that the first or second inner catheter is in a left ventricle while deflecting away the chordae tendinae,
steering the first inner catheter or the second inner catheter towards an aortic valve;
advancing a guidewire distally from the first inner catheter or the second inner catheter and across the aortic valve of the heart into the aortic arch;
advancing the outer catheter and first inner catheter or the second inner catheter over the guidewire to the aortic valve;
removing the first inner catheter or the second inner catheter by disengaging the distal region of the first inner catheter or the second inner catheter that is flush with the outer catheter from the outer catheter; and performing a procedure through the outer catheter.
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