Coronary artery by-pass method

• US 20020092535A1
• Filed: 02/05/2002
• Published: 07/18/2002
• Est. Priority Date: 06/19/1996
• Status: Abandoned Application

• Current Assignee: WILK Patent Development Corporation
• Original Assignee: WILK Patent Development Corporation
• Inventors: Wilk, Peter J.
• Application Number:
  US10/062,409
• Publication Number:
  US 20020092535A1
• Time in Patent Office: Days
• US Class Current: 128/898
• CPC Class Codes: A61B 17/2202 the ultrasound transducer being inside patient's body at the distal end of the catheter
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00106 ultrasonic
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/00703 correcting for movement of heart, e.g. ECG-triggered
• CPC Class Codes: A61B 2017/22021 electric leads passing through the catheter
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61B 2034/2059 Mechanical position encoders
• CPC Class Codes: A61B 2034/2063 Acoustic tracking systems, e.g. using ultrasound
• CPC Class Codes: A61B 2090/061 for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/3784 both receiver and transmitter being in the instrument or receiver being also transmitter
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61F 2/2493 Transmyocardial revascularisation [TMR] devices
• CPC Class Codes: A61M 2210/125 Heart
• CPC Class Codes: A61M 25/0068 Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
• CPC Class Codes: A61M 25/0082 Catheter tip comprising a tool

Abstract

A cardiovascular treatment method utilizes an elongate flexible surgical instrument (e.g., catheter) having a distal end. A distal end portion of the instrument is inserted into a vascular system of a patient. A surgical head at the distal end of the instrument is positioned so that the head is disposed adjacent to myocardium tissue of the patient. The head is operated to form a recess in the myocardium tissue. Prior to operating the head to form the recess, a thickness of the myocardium tissue is measured, the recess formed during the operation having a length determined in accordance with the measured thickness of the myocardium tissue. The thickness measurement partially determines the length of the recess. The angle of entry of the recess with respect to the heart wall also partially determines the length of the recess: the greater the angle, the longer the recess can be for a given myocardium thickness.

Claims

1. A cardiovascular treatment method comprising the steps of:

providing an elongate flexible surgical instrument having a distal end;

inserting a distal end portion of said instrument into a vascular system of a patient;

disposing a surgical head at said distal end of said instrument so that said head is disposed adjacent to myocardium tissue of the patient;

operating said head to form a recess in the myocardium tissue; and

prior to operating said head to form said recess, measuring a thickness of said myocardium tissue, said recess having a length determined in accordance with the measured thickness of said myocardium tissue.

2. The method set forth in claim 1 wherein measuring said thickness includes generating an ultrasonic pressure wave, sensing reflected pressure waves and analyzing the reflected pressure waves to determine said thickness.

3. The method set forth in claim 2 wherein the generating of said ultrasonic pressure wave includes operating a transducer disposed at said distal end of said instrument.

4. The method set forth in claim 1 wherein measuring said thickness includes operating a magnetic resonance imaging machine.

5. The method set forth in claim 1 wherein measuring said thickness includes operating a computer aided tomography scanning machine.

6. The method set forth in claim 1 wherein measuring said thickness includes taking an echocardiogram.

7. The method set forth in claim 1 wherein said recess terminates in said myocardium tissue.

8. The method set forth in claim 1 wherein distal end portion is inserted into a left ventricle of the patient, said head being disposed adjacent to an inner side of said myocardium tissue, inside said left ventricle, said recess extending from said left ventricle into said myocardium tissue.

9. The method set forth in claim 8 wherein said recess terminates in said myocardium tissue.

10. The method set forth in claim 1 wherein said surgical head is a contact laser tip, the operating of said head including transmitting monochromatic coherent electromagnetic radiation through said tip to said myocardium tissue.

11. The method set forth in claim 1 wherein said surgical head includes a drill tip, the operating of said head including pushing said drill tip into said myocardium tissue and rotating said drill tip during said step of pushing.

12. The method set forth in claim 1 wherein the operating of said surgical head is implemented during diastole.

13. The method set forth in claim 12, further comprising operating a computer to synchronize the operating of said surgical head with the rhythm of said heart.

14. The method set forth in claim 1 wherein said surgical head is operated so that said recess extends only partially through said myocardium tissue from a coronary artery of the patient.

15. The method set forth in claim 1 wherein said surgical head is operated so that said recess extends only partially through said myocardium tissue from the left ventricle of the patient.

17. The method set forth in claim 16 wherein said step of directing includes the steps of, during diastole, guiding blood into said myocardium through said recess and, during systole, closing said recess.

16. A method for supplying blood to the heart, comprising the step of directing blood directly into the myocardium via at least one recess formed surgically in the myocardium and extending only partially through the myocardium and only within the myocardium.