Abstract: A system and method of marking percutaneous myocardial revascularization channels in a human heart and introducing into the channels a therapeutic or diagnostic agent by inserting a catheter system into the left ventricle of a heart, applying tissue ablative energy through the catheter to create a channel into the heart wall, introducing an imaging medium to the heart wall proximate the channel for marking the position of that channel for imaging, and introducing in or proximate the channel a therapeutic or diagnostic agent.

Abstract: Cardiac laser surgery apparatus including a CO2 slab laser, and a laser delivery system for delivering laser pulses from the laser to a patient's heart.

Abstract: A percutaneous mapping system includes a mapping wire, for percutaneous insertion into an internal body cavity, having a plurality of spaced imaging markers; and an insertion device for deploying the mapping wire in a spiral configuration inside the cavity with the markers distributed about the inner wall of the cavity.

Abstract: A system and method of marking percutaneous transmyocardial revascularization channels in a human heart includes inserting a catheter system into the left ventricle of a heart, applying tissue ablative energy through the catheter to create a channel into the heart wall, and introducing an imaging medium to the heart wall proximate the channel for marking the position of that channel for imaging.

Abstract: A surgical laser handpiece comprising: an outer barrel having an inner chamber; an inner zoom barrel movable in said chamber relative to said outer barrel; at least a first lens device in said zoom barrel for propagating and focusing a laser beam; and a drive member externally accessible on said outer barrel for moving said zoom barrel with one hand relative to said outer barrel for varying the focus of the laser beam.

Abstract: A sensor system for detecting concealed blood vessels including a handpiece having a passage for transmitting a laser beam and a detector housing at the distal end of the handpiece, the housing including a common electrode, a plurality of segmented electrodes spaced from the common electrode and between the common electrode and the segmented electrodes a plurality of four sensitive elements having an electrical characteristic which varies with the force applied; and an indicator device responsive to variations in the electrical characteristic for representing the presence of a concealed vessel.

Abstract: A gauging system for monitoring channel depth in percutaneous endocardial revascularization surgery includes a catheter for percutaneous insertion into a heart chamber, including a source of tissue ablative energy for ablating a part of the wall of the heart chamber where a channel is to be created; a sensor device proximate the distal end of the catheter for sensing a boundary of the heart wall proximate the channel; and a detection circuit, responsive to the sensor device, for determining the position of the terminus of the channel in the heart chamber; alternatively, a mechanical stop extending radially beyond the distal tip may be used for physically limiting penetration of the catheter tip into the drilled channels.

Abstract: A surgical laser handpiece comprising: an outer barrel having an inner chamber; an inner zoom barrel movable in said chamber relative to said outer barrel; at least a first lens device in said zoom barrel for propagating and focusing a laser beam; and a drive member externally accessible on said outer barrel for moving said zoom barrel with one hand relative to said outer barrel for varying the focus of the laser beam.

Abstract: A video assisted thoracoscopic transmyocardial revascularization (TMR) surgical method includes making at least two spaced incision ports between the ribs of a patient proximate the patient's heart; inserting through one of the ports a thoracoscopic TMR handpiece assembly for creating a channel through the heart wall; inserting through the other incision port a thoracoscope connected to a video display system; viewing the heart of the patient through the video display system and positioning the handpiece assembly relative to the heart; and actuating the handpiece assembly to create a channel through the wall of the patient's heart.

Abstract: A catheter navigation apparatus includes a catheter system for percutaneous insertion into an internal organ cavity. The catheter system includes a treatment catheter and a navigation catheter; the navigation catheter includes a deployable framework at its distal end; the treatment catheter includes at least one conduit extending from its proximal to its distal end; the conduit having its distal end engaged with the framework; the navigation catheter includes a flexible link interconnecting the framework with a control mechanism at the proximal end of the navigation catheter for driving the link to deploy and retract the framework to guide the distal tip of the treatment catheter to target one or more selected positions on the inner wall of the organ cavity.

Abstract: An ultrasonic detection system for transmyocardial revascularization (TMR) is disclosed using a detector in the TMR handpiece for detecting concealed coronary blood vessels as well as verifying completion of transmural TMR channels by displaying the detector's output on a video monitor or analyzing the detector output electronically to identify those conditions.

Abstract: A thoracoscopic transmyocardial revascularization handpiece assembly for a medical laser system which includes a barrel which fits between the patient's ribs, a handpiece which fits between the ribs, a contacting surface on one end of the handpiece with a width which fits between the patient's ribs, and a contacting surface which has a length larger than the width resulting in a contact surface with a surface area which is greater than the cross-sectional area of the handpiece and which yet still fits between the patient's ribs.

Abstract: A thoracoscopic cannula system includes a cannula having an enlarged limiter flange and an elongated hollow tube for insertion between the ribs of a thoracic patient; the tube includes first and second opposed concave recesses for snap-fitting and interlocking with the adjacent ribs to securely anchor it; and an introducer including an elongated member slidably received in the hollow tube with a stop flange at one end to limit movement of the introducer through the tube and a beveled, blunted surface at the other end for gently penetrating and leading the cannula through an incision between the ribs of the patient.