Abstract: An apparatus for transmitting laser light and redirecting the light laterally relative to an axis of the apparatus includes an optical fiber having both a core and a cladding surrounding the core. The optical fiber terminates at a distal tip having a surface inclined relative to the axis of the optical fiber. A tubular member surrounds the optical fiber at its distal end. The distal end of the optical fiber has a portion opposing the tubular member for being united to the tubular member. The distal portion is joined to the tubular member by an intermediate material selected to have an index of refraction matching that of the core and the tubular member.

Abstract: An apparatus for transmitting laser light and redirecting the light laterally relative to an axis of the apparatus includes an optical fiber having both a core and a cladding surrounding the core. The optical fiber terminates at a distal tip having a surface inclined relative to the axis of the optical fiber. A tubular member surrounds the optical fiber at its distal end. The distal end of the optical fiber has a portion opposing the tubular member for being united to the tubular member. The distal portion is joined to the tubular member by an intermediate material selected to have an index of refraction matching that of the core and the tubular member.

Abstract: A method and apparatus for treating in situ biologic tissue include identifying a patient with a condition susceptible to treatment by forming a lesion in the tissue and accessing a surface of the tissue. A lesion formation tool is positioned against the accessed surface. The tool includes an optical fiber for guiding a coherent waveform of a selected wavelength to a fiber tip for discharge of light energy from the fiber tip. The wavelength is selected for the light energy to penetrate a full thickness of the tissue to form a volume of necrosed tissue through the thickness of the tissue. The tool further includes a guide tip coupled to the fiber tip. The guide tip is adapted to have a discharge bore aligned with the fiber tip to define an unobstructed light pathway from the fiber tip to the tissue surface.

Abstract: A method and apparatus for treating atrial tissue include positioning a lesion formation tool against the atrial surface. An optical fiber of the tool is energized at a wavelength is selected to form a volume of necrosed tissue through the thickness of the atrial tissue. A guide member is attached to the tip of the fiber. The guide member is slidable along the surface of the atrial tissue in atraumatic sliding engagement.

Abstract: A method and apparatus for forming a lesion in tissue along a desired ablation path with treating a body tissue in situ (e.g., an atrial tissue of a heart to treat) atrial fibrillation include a lesion formation tool including is positioned against the heart surface. The lesion formation tool includes a guide member having a tissue-opposing surface for placement against a heart surface. An ablation member is coupled to the guide member to move in a longitudinal path relative to the guide member. The guide member includes a track. A carriage is slidably received with the track. The ablation member is secured to the carriage for movement therewith. The guide member includes a visualization component.

Abstract: A method and apparatus for treating a body tissue in situ (e.g., an atrial tissue of a heart to treat) atrial fibrillation include a lesion formation tool is positioned against the heart surface. The lesion formation tool includes a guide member having a tissue-opposing surface for placement against a heart surface. An ablation member is coupled to the guide member to move in a longitudinal path relative to the guide member. The ablation member has an ablation element for directing ablation energy in an emitting direction away from the tissue-opposing surface. The guide member may be flexible to adjust a shape of the guide member for the longitudinal path to approximate the desired ablation path while maintaining the tissue-opposing surface against the heart surface. In one embodiment, the ablation member includes at least one radiation-emitting member disposed to travel in the longitudinal pathway. Transmurality can be assessed to approximate a location of non-transmurality in a formed lesion.

Abstract: An apparatus for treating a biological tissue of a patient in situ includes an optical fiber for guiding a coherent waveform of a selected wavelength to a fiber tip. The wavelength is selected to have a low absorption in water. The fiber tip is contained within a guide member having a discharge bore to define an unobstructed light pathway. The guide member is adapted to be slidable along a tissue surface in atraumatic sliding engagement with the discharge bore opposing the surface. The guide member is carried on an elongated flexible member.

Abstract: A method and apparatus for treating atrial tissue include positioning a lesion formation tool against the atrial surface. An optical fiber of the tool is energized at a wavelength is selected to have a low absorption in water.

Abstract: An apparatus for forming a lesion in cardiac tissue includes an optical fiber for guiding a coherent waveform of a selected wavelength to a fiber tip. The wavelength is selected to have a low absorption in water. The fiber tip is contained within a guide member having a discharge bore for a direction of energy discharge to define an unobstructed light pathway from the fiber tip through a discharge end of the discharge bore. A fluid pathway is in fluid flow communication with the guide member to admit a bio-compatible flushing fluid to the discharge bore.

Abstract: A method and apparatus for treating in situ biologic tissue include identifying a patient with a condition susceptible to treatment by forming a lesion in the tissue and accessing a surface of the tissue. A lesion formation tool is positioned against the accessed surface. The tool includes an optical fiber for guiding a coherent waveform of a selected wavelength to a fiber tip for discharge of light energy from the fiber tip. The wavelength is selected for the light energy to penetrate a full thickness of the tissue to form a volume of necrosed tissue through the thickness of the tissue. The tool further includes a guide tip coupled to the fiber tip. The guide tip is adapted to have a discharge bore aligned with the fiber tip to define an unobstructed light pathway from the fiber tip to the tissue surface.

Abstract: A method and apparatus for treating in situ biologic tissue include identifying a patient with a condition susceptible to treatment by forming a lesion in the tissue and accessing a surface of the tissue. A lesion formation tool is positioned against the accessed surface. The tool includes an optical fiber for guiding a coherent waveform of a selected wavelength to a fiber tip for discharge of light energy from the fiber tip. The wavelength is selected for the light energy to penetrate a full thickness of the tissue to form a volume of necrosed tissue through the thickness of the tissue. The tool further includes a guide tip coupled to the fiber tip. The guide tip is adapted to have a discharge bore aligned with the fiber tip to define an unobstructed light pathway from the fiber tip to the tissue surface.

Abstract: A method and apparatus for treating in situ biologic tissue include identifying a patient with a condition susceptible to treatment by forming a lesion in the tissue and accessing a surface of the tissue. A lesion formation tool is positioned against the accessed surface. The tool includes an optical fiber for guiding a coherent waveform of a selected wavelength to a fiber tip for discharge of light energy from the fiber tip. The wavelength is selected for the light energy to penetrate a full thickness of the tissue to form a volume of necrosed tissue through the thickness of the tissue. The tool further includes a guide tip coupled to the fiber tip. The guide tip is adapted to have a discharge bore aligned with the fiber tip to define an unobstructed light pathway from the fiber tip to the tissue surface.

Abstract: A method and apparatus for treating in situ biologic tissue include identifying a patient with a condition susceptible to treatment by forming a lesion in the tissue and accessing a surface of the tissue. A lesion formation tool is positioned against the accessed surface. The tool includes an optical fiber for guiding a coherent waveform of a selected wavelength to a fiber tip for discharge of light energy from the fiber tip. The wavelength is selected for the light energy to penetrate a full thickness of the tissue to form a volume of necrosed tissue through the thickness of the tissue. The tool further includes a guide tip coupled to the fiber tip. The guide tip is adapted to have a discharge bore aligned with the fiber tip to define an unobstructed light pathway from the fiber tip to the tissue surface.

Abstract: A bileaflet heart valve comprising an annular base and pivoting leaflets. Each leaflet is “free-floating” within recesses without fixed rotational axis in order to increase translational movement and redistribute stresses. Each recess fluidly communicates with a groove extending at least partially around the inner surface of the annular base and fluid flow is directed through the recesses at different angles during antegrade circulation, retograde circulation, and valve closure. A recess entrance angle to each of the recesses in certain embodiments is preferably less than about 35° and the pivoting mechanism within each recess includes first and second fulcrum edges of each leaflet shiftably engaged with side surfaces of the respective recesses. The leaflets have a beveled bottom side having two separate planar surfaces which lie at an angle to one another.