A cryogenic medical system and method of use thereof for transseptal puncturing is disclosed, including a medical device having an elongate body with a fluid flow path therein, a thermally-transmissive region coupled to the elongate body in thermal communication with the fluid flow path, and a puncturing element movably coupled to the elongate body and a cryogenic coolant source in fluid communication with the fluid flow path. The medical device may alternatively include an elongate body, a thermally-transmissive region coupled to the elongate body, a thermo-electric cooler in thermal communication with the thermally-transmissive region, and a puncturing element movably coupled to the elongate body.
