Systems and methods for transseptal delivery of therapeutic devices

A system for delivering a percutaneous ventricular assist device (pVAD) to a target site in a heart of a patient, comprising:

• a pVAD having an advancer on its distal end, the advancer comprising
• an elongate flexible element with a diameter at a distal end of the elongate flexible member and
• a tip element on the distal end of the elongate flexible member, the tip element having a diameter that is greater than the diameter of the distal end of the elongate flexible member;
• and
• a flexible member proportioned for introduction into a vasculature and having a length to extend from the right subclavian vein, through the heart via a transseptal puncture, and to a femoral artery such that a first end of the cable is external to the patient at the right subclavian vein and a second end of the cable is external to the patient at the femoral artery, the flexible member having a first end releasably engageable with the tip element on the elongate flexible element of the pVAD.