A handpiece for use in transmyocardial revascularization heart-synchronized pulsed laser system includes a barrel having a passage for transmitting a laser beam; a surface at the distal end of the barrel for contacting the wall of the heart; an aperture located at the distal end of the barrel and the enlarged surface for transmitting the laser beam; and means for focusing the laser beam proximate to the aperture to vaporize the tissue of the heart wall and create a hole to the interior heart chamber.
This is a continuation of application Ser. No. 08/014,363, filed Feb. 5, 1993 (now abandoned) which is a continuation of application Ser. No. 07/928,531, filed Aug. 13, 1992 (now abandoned) which is a continuation application of Ser. No. 07/586,891 filed Sep. 24, 1990 (now abandoned).
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.
Electrophysiological methods and apparatus are disclosed. An exemplary myocardial treatment method includes the steps of positioning an electrode on the epicardial surface of a ventricle and transmitting energy from the electrode, through the epicardial surface and into the ventricular wall to create a lesion within the ventricular wall. An exemplary apparatus includes a shaft and one or more electrodes that have a main portion and a needle portion.
Electrophysiological methods and apparatus are disclosed. An exemplary myocardial treatment method includes the steps of positioning an electrode on the epicardial surface of a ventricle and transmitting energy from the electrode, through the epicardial surface and into the ventricular wall to create a lesion within the ventricular wall. An exemplary apparatus includes a shaft and one or more electrodes that have a main portion and a needle portion.
