Laser device for transmyocardial revascularization procedures including means for enabling a formation of a pilot hole in the epicardium
First Claim
1. A transmyocardial revascularization (TMR) hand-held device for performing TMR on a patient'"'"'s heart, the device 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;
an optical fiber having a proximal end configured for connecting to a laser energy source, the optical fiber extends through the handle portion, the neck portion and the head portion;
an adjustment means disposed on the handle portion for moving the optical fiber within the handle and neck portions and head portion; and
irradiation control means for providing reduced laser pulse energy from the optical fiber'"'"'s distal end at a first position proximate to the epicardium thereby enabling formation of a pilot hole in the epicardium,wherein the optical fiber can thereafter be moved axially from the first position by the adjustment means and allow nonreduced laser energy to emanate from the optical fiber'"'"'s distal end whereby enabling formation of a myocardial revascularization channel.
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Accused Products
Abstract
An apparatus for performing a laser myocardial revascularization of a human heart comprises a hand-held device with an elongated flexible lasing assembly including an axially movable fiber bundle which can be placed into the chest cavity of a patient. At the distal head end of the device laser energy from the distal end of the fiber bundle is initially reduced to form a relatively small opening in the epicardium of the heart. The fiber bundle is moved through the opening so that lasing with full laser power takes place beneath the epicardium to form a larger channel through the myocardium that extends into the left ventricular cavity. After the channel has been formed, the optical fiber bundle is retracted from the channel and back through the small epicardium opening so as to minimize operative bleeding and allow sealing of the epicardium after the apparatus is removed.
115 Citations
19 Claims
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1. A transmyocardial revascularization (TMR) hand-held device for performing TMR on a patient'"'"'s heart, the device 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; an optical fiber having a proximal end configured for connecting to a laser energy source, the optical fiber extends through the handle portion, the neck portion and the head portion; an adjustment means disposed on the handle portion for moving the optical fiber within the handle and neck portions and head portion; and irradiation control means for providing reduced laser pulse energy from the optical fiber'"'"'s distal end at a first position proximate to the epicardium thereby enabling formation of a pilot hole in the epicardium, wherein the optical fiber can thereafter be moved axially from the first position by the adjustment means and allow nonreduced laser energy to emanate from the optical fiber'"'"'s distal end whereby enabling formation of a myocardial revascularization channel. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15)
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16. A method for myocardial revascularization of a patient'"'"'s heart comprising the steps of:
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a) providing access to the patient'"'"'s heart and positioning an optical fiber whose proximal end connects to a laser source and whose distal end is for laser pulse emissions, the optical fiber'"'"'s distal end initially is juxtaposed to an irradiation control means for providing reduced laser pulse emissions from the optical fiber at an initial position; b) placing the optical fiber'"'"'s distal end near the heart'"'"'s surface at the initial position; c) pulsing the laser source at the initial position forming a pilot hole in the epicardium; d) advancing the optical fiber past the irradiation control means through the pilot hole; and e) pulsing the laser source while advancing the optical fiber'"'"'s distal end into the heart'"'"'s myocardium thereby allowing non-reduced laser energy to emanate from the optical fiber'"'"'s distal end and forming a revascularizing channel. - View Dependent Claims (17, 18, 19)
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Specification