Laser device with piercing tip for transmyocardial revascularization procedures
First Claim
1. A hand-held transmyocardial revascularization (TMR) device for performing TMR on a patient'"'"'s heart comprising:
- a handle portion;
a tubular neck portion connected to the handle portion;
a head portion on a distal end of the tubular neck portion, the head portion forming a distal end contact surface for engaging the heart'"'"'s epicardium;
an optical fiber having a proximal end configured for connecting to a laser energy source, the optical fiber extending through the handle portion and into the neck portion with a distal end of the optical fiber within the head portion;
adjustment means for moving the optical fiber within the handle portion, neck portion and head portion, the adjustment means is disposed on the handle portion;
thereby enabling movement of the optical fiber'"'"'s distal end beyond the head portion; and
piercing means for;
a) making an initial opening in the epicardium and b) allowing the optical fiber'"'"'s movement therethrough when moved by the adjustment means, the piercing means is;
i) axially movable relative to the head portion and ii) coupled to the head portion,whereby laser irradiation from the optical fiber'"'"'s distal end forms a revascularizing channel in the heart'"'"'s myocardium.
1 Assignment
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Accused Products
Abstract
The method for combined mechanical/laser myocardial revascularization of a human heart includes: inserting a mechanical piercing device and an elongated flexible lasing apparatus into the chest cavity of a patient; mechanically piercing, micro-tearing or spreading the epicardium of the heart; and then lasing from beneath the epicardium through the myocardium. The apparatus is guided to an area exterior to a ventricle of the patient'"'"'s heart, and the distal end of the optical fiber apparatus is placed internal to the exterior wall of the heart through an opening which has been created by mechanically piercing, micro-tearing or spreading the epicardium, so that the myocardium and not the epicardium is irradiated with laser energy to allow passage of said optical fiber distal end or said laser energy into the left ventricular cavity without causing a laser irradiation of the epicardium which might be a cause of operative bleeding and for better allowing the sealing of the epicardium after the apparatus is removed. The apparatus includes a hand-held device controllable by the surgeon having a removable distal head end with a replaceable piercing member and utilizing a vacuum source to provide a suction force at the head end.
91 Citations
21 Claims
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1. A hand-held transmyocardial revascularization (TMR) device for performing TMR on a patient'"'"'s heart comprising:
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a handle portion; a tubular neck portion connected to the handle portion; a head portion on a distal end of the tubular neck portion, the head portion forming a distal end contact surface for engaging the heart'"'"'s epicardium; an optical fiber having a proximal end configured for connecting to a laser energy source, the optical fiber extending through the handle portion and into the neck portion with a distal end of the optical fiber within the head portion; adjustment means for moving the optical fiber within the handle portion, neck portion and head portion, the adjustment means is disposed on the handle portion;
thereby enabling movement of the optical fiber'"'"'s distal end beyond the head portion; andpiercing means for;
a) making an initial opening in the epicardium and b) allowing the optical fiber'"'"'s movement therethrough when moved by the adjustment means, the piercing means is;
i) axially movable relative to the head portion and ii) coupled to the head portion,whereby laser irradiation from the optical fiber'"'"'s distal end forms a revascularizing channel in the heart'"'"'s myocardium. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15)
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16. A method of transmyocardial revascularization on a human heart, the method comprising the steps of:
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a) providing a tubular piercing member whose distal end is a tapered tip with a means for cushioning the piercing member, the piercing member has a movable optical fiber disposed within the piercing member, the optical fiber'"'"'s proximal end connects to a laser energy source; b) forcing and cushioning the piercing member against a surface of the heart; c) piercing the heart'"'"'s surface while exerting axial force to the piercing member; d) advancing the optical fiber'"'"'s distal end beyond the tapered tip; and e) emitting laser energy from the distal end forming a revascularizing channel. - View Dependent Claims (17, 18, 19, 20, 21)
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Specification