wires and or contrast media that may be inserted through the lumen of the transseptal needle shaft 610 to allow the physician to confirm left atrial cannulation after septum puncture in another aspect of the puncture tip 622 as best seen in fig1 the distal tip portion 625 of the needle 622 comprises a solid construct proximal of the solid tip portion 625 a flush hole channel 632 is continuous with the lumen 700 of first cannula 624 and co extensive with the lumen 620 of shaft 610 and includes an exit hole 634 positioned to the side of the puncture tip 622 flush hole with its channel 632 serve as an exit conduit for contrast media or a guidewire the contrast media or guidewire allow the physician to confirm left atrial cannulation after septum puncture in yet other aspects of the puncture tip 622 in accordance with the invention and as best seen in fig1 through 17 the distal portion 625 of puncture tip 622 is completely solid and has a conical shape those of skill in the art will appreciate however that distal tip 625 can be of any shape such as fluted triangular trocar shaped chiseled without departing from the invention so long as the tip is capable of piercing through tissue proximal of the puncture tip 622 are one or more flush holes that penetrate both the first and second cannulas 624 626 to access their lumens such that contrast media can be injected into the needle and exit at these locations the flush hole locations may be drilled in a variety of patterns and configurations including 90 degree staggered fig1 180 degree opposed fig1 180 degree staggered fig1 and like configurations those of skill in the art will also appreciate that any.