Abstract: A laser catheter for irradiation of human myocardial tissue containing a fixed feedback mechanism for monitoring the damage created by laser irradiation, and which is usable with standard catheters designed for angiography and angioplasty. Means for sensing distal temperature are provided in the form of a plurality of thermocouples, along with the ability to cool the fiber optic and distal tip with a flushing solution. Flushing of the area adjacent to the tip is provided for by a fluid which travels the length of the laser catheter. A dissolvable tip covering at the distal end facilitates passage of a very sharp point through a guiding catheter or vasculature.

Abstract: A defibrillation catheter having a connection from an electrode to an infeed conductor in the mid-point area of the electrode. The mid-point current feed provides for a voltage drop from the center of the electrode to its ends, which minimizes extreme electrical fields which normally develop at the electrode ends. The coil resistance is selected to further optimize the field distribution so as to allow a large passage of defibrillation current without cell damage.

Abstract: A separation device to insulate implantable elements in the right ventricle of the heart. The separation devices include peripheral structures that are constructed and arranged to mount to one of the implantable elements. Further disclosed are collapsible, compressible and resilient separation structures and those molded of biodegradable and soluble compositions.

Abstract: A low impedence defibrillation catheter electrode having a high effective conductive length for implantation in the right ventricle of the heart. The catheter electrode conductive body has at least one flexible and resilient extension member extending angularly therefrom. The flexible and resilient conductive members provide an increased effective length to the catheter electrode and permit collapse into a small diameter configuration for insertion into an introducer structure for implantation through a venous approach.

Abstract: A defibrillator pulse generator device for implantation in the pectoral position of a patient. The pulse generator device has a compact, light weight housing structure. A power source, a capacitive member and a sensing and control structure are enclosed in the housing structure. A connecting structure mounted on the housing provides connection to the electrode leads of the defibrillator system.

Abstract: An implantable defibrillator comprising a first implantable energy source connected to an implantable monitoring circuit means and a second implantable energy source having a predetermined different energy output than said first implantable energy source connected to an implantable inverter/output circuit means. The implantable monitoring circuit is powered by the first implantable energy source and the implantable inverter/output circuit is powered by the second implantable energy source.

Abstract: The method of generating a homograft includes preparing a prosthesis composed of a tubular substrate. The substrate is open at each end to permit blood to flow along the length of the substrate inside wall. The substrate is selected to have at least one thrombogenic surface or a thrombogenic mesh material supported by the substrate. The prosthesis is inserted in the lumen of a blood vessel, either a vein or artery, of a living body and anchored in the lumen of the vessel to prevent the substrate from moving along the vessel with the blood flow. The body generates collagenous growth on the thrombogenic surface of the substrate while the substrate is freely suspended in the blood flow of the vessel. The substrate is then removed from the vessel after which a tubular homograft of collagenous tissue is removed from the substrate.

Abstract: A balloon consisting of braided fibers encapsulated between two plastic elastomeric materials affixes to a distal end of a catheter. The braided fibers provide reinforcement to contain pressure and determine the maximum diameter of the balloon on expansion. The elastomeric material provides for fluid containment and collapsing of the balloon after pressurization. An embedded spring in an elastomeric material internal to the catheter provides memory to assist in collapsing the balloon after pressurization. The embedded spring extends from the distal end of the catheter towards the proximal end of the catheter along a substantial length of the catheter. The catheter with the balloon are in a multilumen configuration or in a coaxial configuration. A guidewire passage extends through the elastomeric material with the embedded spring.

Abstract: A balloon consisting of braided fibers encapsulated between two plastic elastomeric materials affixes to a distal end of a catheter. The braided fibers provide reinforcement to contain pressure and determine the maximum diameter of the balloon on expansion. The elastomeric material provides for fluid containment and collapsing of the balloon after pressurization. An embedded spring in an elastomeric material internal to the catheter provides memory to assist in collapsing the balloon after pressurization. The embedded spring extends from the distal end of the catheter towards the proximal end of the catheter along a substantial length of the catheter. The catheter with the balloon are in a multilumen configuration or in a coaxial configuration. A guidewire passage extends through the elastomeric material with the embedded spring.

Abstract: A process for providing a biological pacemaker for the human heart wherein the sino-atrial (S-A) node cells are removed from the heart and cultured to generate a critical mass of S-A node cells of sufficient quantity to generate a depolarization wave capable of stimulating the cells of the myocardium to ensure normal or near-normal pumping action in the heart. The critical mass of S-A node cells are then implanted in the myocardial tissue of the right ventricle to provide biological pacing for the heart which is sensitive to and variable with normal increase and decrease of output demands on the heart.

Abstract: A locking clip for placement between a dilator and a sheath for releasably securing a dilator and a sheath together during an insertion procedure. The locking clip includes a back support, a snap ring for engaging about a hub of the dilator at one end of the back support and at least one tooth at a lower end of the back support for engaging under a tab of the sheath. The sheath can be a tear-away sheath.

Abstract: A pressure gauge including a bourdon tube where a substantial portion of the pressure gauge is filled with a silicone gel, gelatinous material, or any other suitable materials.

Abstract: A cardiac sensing lead which is placed and used on the epicardial surface of the heart. The lead consists of a screw-in electrode which acts as the cathode and a mesh of platinum/iridium that acts as the anode. The electrodes' effective distances from each other are no longer than lcm. The screw-in electrode also acts as the anchor in the tissue and is implanted with a lead applicator. The cardiac sensing lead senses cardiac signals for the application for diagnostic purposes such as for an internal defibrillator or any other external or internal medical devices.

Abstract: A lead insertion tool of a molded polymer including a main body and two movable fingers extending at an angle from one end of the main body for holding a cardiac sensing lead or cardiac pacing lead. The inner ends of the fingers are configured to grasp a pacing lead electrode body. A tubular member with finger tabs extends down and over the main body and down and over the extending fingers so that the ends of the fingers movingly engage about the pacing lead body when the tubular member is slid down the body of the lead insertion tool. The inner ends of the extending fingers can be geometrically configured to accept any particular pacing lead body member supporting the electrodes of the pacing lead.

Abstract: A medical instrument holder, also referred to as a packaging clip, for supporting disposable medical instruments for cardiology and cardiovascular procedures. The medical instrument holder is a one-piece polymer molded member, including a frictionally engaged tube, in the holder for supporting a guidewire. The holder also includes at least one slot for a medical instrument in the form of a partial circle to prevent axial movement, and preferably two slots for frictionally engaging a dilator and a hemostasis valve introducer, or a needle and a tear-away sheath/dilator assembly. The holder can also include at least one hole for receiving a medical instrument. The one-piece molded member, including the frictionally engaged guidewire tube, provides for disposable packaging in a Tyvek/Mylar pouch which lends itself conveniently to ETO sterilization. The holder, along with its instruments, is compact and minimal in length because the guidewire is looped about itself.

Abstract: A technique for percutaneous treatment of idiopathic hypertropic subaortic stenosis (IHSS) and hypertrophic cardiomyopathy (HCM). IHSS and HCM are diseases of the heart in which the septum of the left ventricle thickens resulting in reduced ventricular performance. Current treatments involve drug therapy or a medical intervention called an interoperative myotomy/myectomy using the Morrow procedure. The present invention uses laser energy delivered via fiber optics placed percutaneously to irradiate the thickened septum to reduce tissue volume of the septum and enhance left ventricular function.

Abstract: This invention is described and illustrated in connection with the generation of a homograft composed of collagenous tissue generated on a prosthetic device. A tubular substrate having generally cylindrical outside and inside surfaces is suspended in the lumen of a blood vessel of a living body. The tubular substrate is open at each end to permit blood to flow over both the inside and outside surfaces. One of the surfaces of the substrate is a thrombogenic surface or supports a thrombogenic mesh material to promote growth of a tube of collagenous tissue suitable for use as a surgical graft. The substrate is suspended in the blood flow of a blood vessel by an anchor which permits the substrate to freely move within the lumen of the vessel but is anchored by the tether to prevent the substrate from moving along the vessel in the direction of blood flow. The collagenous tissue growth about the substrate is generally tubular and suitable for use as a surgical graft.

Abstract: A technique for the treatment of ventricular tachycardia. The ventricles are endocardially mapped by way of an electrophysiological workup. This mapping locates the tachycardial foci and other abnormalities in conduction. A special catheter containing an optical fiber is percutaneously inserted into a blood vessel and advanced into the ventricle. The distal tip of the catheter is positioned adjacent to each of the tachycardia generating sites. A medical laser is used to irradiate each site via the optical fiber. The tissue at each site is thereby photocoagulated or ablated to remove the source of the tachyarythmia.