Steerable endoluminal punch

A transseptal punch comprising:

• an outer tube characterized by a proximal end a distal end, and a flexible region at the distal end, said flexible region characterized by a proximal and a distal end;
• and
• an inner tube characterized by a proximal and a distal end, said inner tube having a flexible region near the distal end thereof and a distal tip adapted to pierce body tissue;
• said inner tube being disposed within the outer tube, extending from the proximal end of the outer tube to the distal end of the outer tube, and terminating distally beyond the distal end of the outer tube, said inner tube fixed to the outer tube at a point in the outer tube proximate the distal end of the flexible region of the outer tube.