Methods and devices for puncturing tissue

A system for treating a medical condition on a left side of a patient's heart using a multi-function guidewire to reduce the number of exchanges required to perform a procedure, the system comprising:

• a multi-function guidewire comprising:
• a proximal section;
• a distal section;
• and
• a rail section between the proximal and distal sections;
• an electrode at an end portion of the distal section;
• wherein the multi-function guidewire is configured to be advanced into a patient's vasculature;
• wherein at least the distal section of the multi-function guidewire is configured to be manipulated through the vasculature to provide access to a right side of the patient's heart independently of an introducer sheath or introductory guidewire;
• wherein the multi-function guidewire is configured to allow the end portion of the distal section to be positioned substantially adjacent a septum of the patient's heart;
• wherein the electrode is configured to create a puncture in the septum to allow the multi-function guidewire to be advanced to the left side of the patient's heart;
• and
• wherein the multi-function guidewire is configured to permit the advancement thereupon of one or more tubular members into the left side of the patient's heart.

A method for treating a medical condition on a left side of a patient's heart using a multi-function guidewire to reduce the number of exchanges required to perform a procedure, the method comprising:

• advancing the multi-function guidewire into the patient's vasculature, the multi-function guidewire comprising a proximal section, a distal section, and a rail section between the proximal and distal sections, wherein at least the proximal section of the multi-function guidewire is disposed within a sheath and dilator assembly, the sheath and dilator assembly including a sheath and dilator;
• positioning the distal section of the multi-function guidewire at a right side of the patient's heart when the distal section of the multi-function guidewire is not disposed within the sheath and dilator assembly;
• advancing the sheath and dilator assembly, over at least a portion of the distal section of the multifunction guidewire;
• positioning an end portion of the distal section substantially adjacent a septum of the patient's heart;
• applying energy to the multi-function guidewire to create a puncture in the septum;
• advancing the distal section of the multi-function guidewire through the puncture and into the left side of the patient's heart;
• advancing the sheath and dilator assembly over the multi-function guidewire through the puncture into the left side of the patient's heart;
• and
• withdrawing at least the multi-function guidewire and the dilator from the patient's vasculature.

A system for treating a medical condition on a left side of a patient's heart using a multi-function guidewire to reduce the number of exchanges required to perform a procedure, the system comprising:

• a multi-function guidewire comprising:
• a proximal section;
• a distal section;
• and
• a rail section between the proximal and distal sections;
• wherein the multi-function guidewire is configured to allow a first sheath to be advanced thereupon;
• wherein the multi-function guidewire is configured to be advanced into the patient's vasculature such that at least the distal section of the multi-function guidewire is positioned at a right side of the patient's heart independently of the first sheath;
• wherein the multi-function guidewire is configured to allow an end portion of the distal section to be positioned substantially adjacent a septum of the patient's heart;
• wherein the multi-function guidewire is electrically conductive to allow energy to be applied thereto to create a puncture in the septum thereby allowing the distal section of the multi-function guidewire to be advanced through the puncture into the left side of the patient's heart;
• wherein the multi-function guidewire is configured to permit the advancement thereupon of the first sheath into the left side of the patient's heart.