Patent ID: 8172747

Claim:
A method for traversing a tissue wall in a body, comprising: endoluminally advancing a direct visualization balloon catheter having an expandable balloon at a distal end and an imaging element into a first cavity opposite a tissue wall from a second cavity; approaching the tissue wall with said balloon catheter; adjusting the relative positioning between the distal end of the balloon catheter and the tissue wall based upon direct visualization feedback; engaging the tissue wall with a distal face of the expandable balloon, which allows a lumen of the balloon catheter to extend through the distal face of the expandable balloon and define a path to the tissue wall; controllably advancing a tissue traversing member out of the lumen of the balloon catheter, through the distal face of the expandable balloon, and through the tissue wall into the second cavity; upon traversing the tissue wall, confirming a position of the traversing member in the second cavity using an endoluminally advanced imaging element or sensing element positioned in the second cavity; and withdrawing the balloon catheter away from the tissue wall, while leaving the tissue traversing member positioned across the tissue wall and in the second cavity.