Fossa ovalis penetration

Apparatus comprising:

• a catheter shaped to define a catheter lumen,
• wherein a wall of the catheter (a) comprises a braided portion, and (b) is shaped to define a first longitudinally-running channel through the wall and a second longitudinally-running channel through the wall, and
• wherein a distal portion of the catheter is shaped to define a first lateral opening and a second lateral opening, and wherein an angle between (a) a first line running between the first and second lateral openings, and (b) a second line that is parallel to a central longitudinal axis of the catheter when the catheter is straight, is between 30 and 150 degrees;
• a flexible longitudinal member that passes (a) from a proximal portion of the catheter to the distal portion of the catheter via the first channel, (b) out of the first channel via the first lateral opening, (c) into the second channel via the second lateral opening, and (d) from the distal portion of the catheter to the proximal portion of the catheter via the second channel;
• and
• a needle shaped to be slidably disposed within the catheter lumen,
• wherein the needle is hollow, and comprises (a) a proximal portion, and (b) a helical distal portion, and
• wherein the apparatus further comprises a fluid-impermeable cover surrounding the helical distal portion of the needle.

Apparatus comprising:

• a catheter shaped to define a catheter lumen,
• wherein a wall of the catheter (a) comprises a braided portion, and (b) is shaped to define a first longitudinally-running channel through the wall and a second longitudinally-running channel through the wall, and
• wherein a distal portion of the catheter is shaped to define a first lateral opening and a second lateral opening, and wherein an angle between (a) a first line running between the first and second lateral openings, and (b) a second line that is parallel to a central longitudinal axis of the catheter when the catheter is straight, is between 30 and 150 degrees;
• a flexible longitudinal member that passes (a) from a proximal portion of the catheter to the distal portion of the catheter via the first channel, (b) out of the first channel via the first lateral opening, (c) into the second channel via the second lateral opening, and (d) from the distal portion of the catheter to the proximal portion of the catheter via the second channel;
• and
• a needle shaped to be slidably disposed within the catheter lumen,
• wherein the needle is hollow, and comprises (a) a proximal portion, and (b) a distal portion that is more flexible than the proximal portion, and
• wherein the apparatus further comprises a fluid-impermeable cover surrounding the distal portion of the needle.

Apparatus comprising:

• a catheter shaped to define a catheter lumen,
• wherein a wall of the catheter (a) comprises a braided portion, and (b) is shaped to define a first longitudinally-running channel through the wall and a second longitudinally-running channel through the wall, and
• wherein a distal portion of the catheter is shaped to define a first lateral opening and a second lateral opening, and wherein an angle between (a) a first line running between the first and second lateral openings, and (b) a second line that is parallel to a central longitudinal axis of the catheter when the catheter is straight, is between 30 and 150 degrees;
• a flexible longitudinal member that passes (a) from a proximal portion of the catheter to the distal portion of the catheter via the first channel, (b) out of the first channel via the first lateral opening, (c) into the second channel via the second lateral opening, and (d) from the distal portion of the catheter to the proximal portion of the catheter via the second channel;
• and
• a needle shaped to be slidably disposed within the catheter lumen,
• wherein the needle is hollow, and comprises (a) a proximal portion, and (b) a distal portion comprising a wall that is shaped to define a plurality of openings that pass completely therethrough, and
• wherein the apparatus further comprises a fluid-impermeable cover surrounding the distal portion of the needle.

Apparatus comprising:

• a catheter shaped to define a catheter lumen,
• wherein a wall of the catheter (a) comprises a braided portion, and (b) is shaped to define a first longitudinally-running channel through the wall and a second longitudinally-running channel through the wall, and
• wherein a distal portion of the catheter is shaped to define a first lateral opening and a second lateral opening, and wherein an angle between (a) a first line running between the first and second lateral openings, and (b) a second line that is parallel to a central longitudinal axis of the catheter when the catheter is straight, is between 30 and 150 degrees;
• a flexible longitudinal member that passes (a) from a proximal portion of the catheter to the distal portion of the catheter via the first channel, (b) out of the first channel via the first lateral opening, (c) into the second channel via the second lateral opening, and (d) from the distal portion of the catheter to the proximal portion of the catheter via the second channel;
• and
• a needle shaped to be slidably disposed within the catheter lumen,
• wherein the needle is hollow, and comprises (a) a proximal portion, and (b) a distal portion comprising an elastomeric tube having an outer surface, an inner surface, and an interior portion between the outer and inner surfaces that is selected from the group consisting of:
• a braided metal interior, and a coiled metal interior.

Apparatus comprising:

• a catheter shaped to define a catheter lumen,
• wherein a wall of the catheter (a) comprises a braided portion, and (b) is shaped to define a first longitudinally-running channel through the wall and a second longitudinally-running channel through the wall, and
• wherein a distal portion of the catheter is shaped to define a first lateral opening and a second lateral opening, and wherein an angle between (a) a first line running between the first and second lateral openings, and (b) a second line that is parallel to a central longitudinal axis of the catheter when the catheter is straight, is between 30 and 150 degrees;
• a flexible longitudinal member that passes (a) from a proximal portion of the catheter to the distal portion of the catheter via the first channel, (b) out of the first channel via the first lateral opening, (c) into the second channel via the second lateral opening, and (d) from the distal portion of the catheter to the proximal portion of the catheter via the second channel;
• and
• a needle shaped to be slidably disposed within the catheter lumen,
• wherein the needle is hollow, and comprises:
• a proximal portion having an outer diameter between 0.7 and 3 mm, a length between 650 and 1200 mm, and a wall thickness between 0.1 and 0.3 mm;
• and
• a distal portion at least partially made of nitinol, the distal portion having an outer diameter between 0.5 and 1.5 mm and a length between 30 and 200 mm.

Apparatus comprising:

• a catheter shaped to define a catheter lumen,
• wherein a wall of the catheter (a) comprises a braided portion, and (b) is shaped to define a first longitudinally-running channel through the wall and a second longitudinally-running channel through the walk and
• wherein a distal portion of the catheter is shaped to define a first lateral opening and a second lateral opening, and wherein an angle between (a) a first line running between the first and second lateral openings, and (b) a second line that is parallel to a central longitudinal axis of the catheter when the catheter is straight is between 30 and 150 degrees:
• a flexible longitudinal member that passes (a) from a proximal portion of the catheter to the distal portion of the catheter via the first channel (b) out of the first channel via the first lateral opening, (c) into the second channel via the second lateral opening, and (d) from the distal portion of the catheter to the proximal portion of the catheter via the second channel:
• a needle shaped to be slidably disposed within the catheter lumen, wherein the needle is electrically conductive;
• one or more conductors;
• and
• a controller, which is coupled to the needle by the one or more conductors, and which is configured to drive the needle to apply energy capable of creating a hole through tissue.