A
system for accessing a patient's cardiac
anatomy which includes an endovascular aortic partitioning device that separates the
coronary arteries and the heart from the rest of the patient's arterial
system. The endovascular device for partitioning a patient's
ascending aorta comprises a flexible shaft having a distal end, a proximal end, and a first inner lumen therebetween with an opening at the distal end. The shaft may have a preshaped
distal portion with a curvature generally corresponding to the curvature of the patient's
aortic arch. An expandable means, e.g. a
balloon, is disposed near the distal end of the shaft proximal to the opening in the first inner lumen for occluding the
ascending aorta so as to block substantially all
blood flow therethrough for a plurality of cardiac cycles, while the patient is supported by
cardiopulmonary bypass. The endovascular aortic partitioning device may be coupled to an arterial bypass cannula for delivering oxygenated blood to the patient's arterial
system. The heart
muscle or myocardium is paralyzed by the retrograde delivery of a cardioplegic fluid to the myocardium through patient's
coronary sinus and coronary veins, or by antegrade delivery of cardioplegic fluid through a lumen in the endovascular aortic partitioning device to infuse cardioplegic fluid into the
coronary arteries. The pulmonary
trunk may be vented by withdrawing liquid from the
trunk through an inner lumen of an elongated
catheter. The cardiac accessing system is particularly suitable for removing the
aortic valve and replacing the removed valve with a
prosthetic valve.