Surgical apparatus for transmyocardial revascularization

摘要

A surgical apparatus (16) is provided for combined mechanical/laser myocardial revascularization of a human heart (10). Use of the apparatus involves inserting a mechanical piercing device (24) and an elongated flexible lasing apparatus into the chest cavity of a patient; mechanically piercing, micro-tearing or spreading the epicardium of the heart (12); 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 (14), and the distal end of the optical fiber apparatus (26) 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. <IMAGE>