Laser device for transmyocardial revascularization procedures

A - Human Necessities – 61 – B

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A61B 18/22 (2006.01) A61B 17/00 (2006.01) A61B 17/02 (2006.01) A61B 17/30 (2006.01) A61F 9/008 (2006.01)

Patent

CA 2201670

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.

Appareil pour exécuter une revascularisation myocardique au laser d'un coeur humain, qui comporte un dispositif à main comprenant un élément au laser allongé et flexible, y compris un faisceau de fibres à déplacement axial qui peut être placé dans la cavité thoracique d'un patient. L'énergie laser de l'extrémité distale du faisceau de fibres, à l'extrémité distale du dispositif, est d'abord réduite afin d'aménager une ouverture relativement petite dans l'épicarde du coeur. Le faisceau de fibres est ensuite introduit dans l'ouverture pour que le laser puisse agir à la puissance maximale, sous l'épicarde afin de creuser dans le myocarde un plus grand canal qui se prolonge jusque dans la cavité ventriculaire gauche. Une fois le canal creusé, le faisceau de fibres optiques est retiré du canal par la petite ouverture de l'épicarde de façon à minimiser le saignement opératoire et de permettre la fermeture de l'épicarde après le retrait de l'appareil.

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