An access catheter provides access for a large bore stiff therapeutic catheter across the atrial septum from above via the superior vena cava. The access catheter has an expandable member that direct a delivery tube outwards in a radial direction to place a delivery tube opening into direct contact with the fossa ovalis. The braided expandable member allows blood flow to pass when it is expanded; the expandable member provides support against the opposite wall of the right atrium. A hollow dilator tube enters the delivery tube to form a tenting shape to the fossa and a guidewire is passed across the fossa ovalis. Standard procedure allows delivery of the therapeutic catheter over the guidewire.
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