Methods and Devices for Creation of Communication Between Aorta and Left Atrium

A method for creating a pathway between an aorta and a left atrium of a patient's heart, comprising:

• a. via a femoral venous access site and a right atrium, advancing a puncture assembly device towards an interatrial septum, wherein said puncture assembly device comprises a sheath, a dilator, and a flexible puncturing device;
• b. positioning a perforating tip of puncturing device adjacent an interatrial septum proximate a left atrium;
• c. advancing the perforating tip to perforate through the interatrial septum creating a pathway between the right atrium and left atrium;
• d. advancing the puncturing device to the left atrium;
• e. advancing the sheath and the dilator over the puncturing device through the septum and into the left atrium such that perforating tip of the puncturing device is aligned with a distal tip of the sheath and a distal tip of the dilator, forming said puncturing assembly;
• f. positioning the puncturing assembly at a target site within the left atrium to gain access to the aorta;
• and
• g. advancing the perforating tip of the puncturing device to perforate through the wall of the left atrium and then through a wall of the aorta, to create a pathway between the aorta and the left atrium.