Abstract: Devices and methods for creating a series of percutaneous myocardial revascularization (PMR) channels in the heart. One method includes forming a pattern of channels in the myocardium leading from healthy tissue to hibernating tissue. Suitable channel patterns include lines and arrays. One method includes anchoring a radiopaque marker to a position in the ventricle wall, then using fluoroscopy repeatedly to guide positioning of a cutting tip in the formation of multiple channels. Another method uses radiopaque material injected into each channel formed, as a marker. Yet another method utilizes an anchorable, rotatable cutting probe for channel formation about an anchor member, where the cutting probe can vary in radial distance from the anchor. Still another method utilizes a multiple wire radio frequency burning probe, for formation of multiple channels simultaneously. Still another method utilizes liquid nitrogen to cause localized tissue death.

Abstract: Devices and methods for creating a series of percutaneous myocardial revascularization (PMR) channels in the heart. One method includes forming a pattern of channels in the myocardium leading from healthy tissue to hibernating tissue. Suitable channel patterns include lines and arrays. One method includes anchoring a radiopaque marker to a position in the ventricle wall, then using fluoroscopy repeatedly to guide positioning of a cutting tip in the formation of multiple channels. Another method uses radiopaque material injected into each channel formed, as a marker. Yet another method utilizes an anchorable, rotatable cutting probe for channel formation about an anchor member, where the cutting probe can vary in radial distance from the anchor. Still another method utilizes a multiple wire radio frequency burning probe, for formation of multiple channels simultaneously. Still another method utilizes liquid nitrogen to cause localized tissue death.

Abstract: A catheter having an elongate shaft including a proximal and a distal end. The shaft includes a conductor. An electrode is disposed at the distal end of the shaft and is connected to the conductor. The electrode has a generally annular, cross-sectional shape. The annular shape defines an opening within the electrode. An insulator surrounds the conductor. In accordance with the method of the present invention, a crater wound can be formed through the endocardium and into the myocardium of a patient's heart. Collateral damage to the myocardium can be made by infusing pressurized fluid into the crater wound.

Abstract: A PMR catheter and associated methods are disclosed. A catheter in accordance with the present invention comprised, an elongate shaft having a proximal portion, a distal portion, and a lumen extending through at least the distal portion thereof, an electrode disposed proximate the distal portion of the elongate shaft, and an electrode lumen defined by the electrode and being in fluid communication with the lumen of the elongate shaft.

Abstract: A catheter having an elongate shaft including a proximal and a distal end. The shaft includes a conductor. An electrode is disposed at the distal end of the shaft and is connected to the conductor. The electrode has a generally annular, cross-sectional shape. The annular shape defines an opening within the electrode. An insulator surrounds the conductor. In accordance with the method of the present invention, a crater wound can be formed through the endocardium and into the myocardium of a patient's heart. Collateral damage to the myocardium can be made by infusing pressurized fluid into the crater wound.

Abstract: Devices and methods for performing percutaneous myocardial revascularization (PMR). A catheter in accordance with the invention includes an elongate shaft having a proximal end and a distal end. The elongate shaft defines a lumen, and a conductor is disposed inside the lumen. An electrode portion is formed by the bent portion of the conductor which extends from the distal end of the elongate shaft. A method in accordance with the present invention may be used to form a wound through the endocardium and into the myocardium of a patient's heart. Collateral damage to the myocardium may be created by infusing pressurized fluid into the wound. A number of fluids may be delivered to a location proximate the wound via the catheter.

Abstract: Devices and methods for performing percutaneous myocardial revascularization (PMR). A catheter in accordance with the invention includes an elongate shaft having a proximal end and a distal end. The elongate shaft defines a lumen, and a conductor is disposed inside the lumen. An electrode portion is formed by the bent portion of the conductor which extends from the distal end of the elongate shaft. A method in accordance with the present invention may be used to form a wound through the endocardium and into the myocardium of a patient's heart. Collateral damage to the myocardium may be created by infusing pressurized fluid into the wound. A number of fluids may be delivered to a location proximate the wound via the catheter.

Abstract: An intravascular device and methods for forming multiple percutaneous myocardial revascularization (PMR) holes in a heart chamber wall simultaneously. One device includes a basket formed of flexible arms carrying cutting probes over their length. The basket arms are outwardly arcuately biased so as to assume an outwardly bowed, arcuate shape when unconstrained. The device includes an inner shaft distally secured to a proximal portion of the basket and slidably disposed within an outer shaft. The inner shaft and collapsed basket can be retracted within the outer shaft, delivered intravascularly to the left ventricle, and distally advanced, forcing the basket to assume the bowed shape. Radio frequency current supplied to the electrical cutting probes burn holes into the ventricle wall and myocardium. One embodiment has high pressure fluid jet cutting means. Another embodiment uses a basket as an anchor to position a steerable cutting probe.

Abstract: Devices and methods for creating a series of percutaneous myocardial revascularization (PMR) channels in the heart. One method includes forming a pattern of channels in the myocardium leading from healthy tissue to hibernating tissue. Suitable channel patterns include lines and arrays. One method includes anchoring a radiopaque marker to a position in the ventricle wall, then using fluoroscopy repeatedly to guide positioning of a cutting tip in the formation of multiple channels. Another method uses radiopaque material injected into each channel formed, as a marker. Yet another method utilizes an anchorable, rotatable cutting probe for channel formation about an anchor member, where the cutting probe can vary in radial distance from the anchor. Still another method utilizes a multiple wire radio frequency burning probe, for formation of multiple channels simultaneously. Still another method utilizes liquid nitrogen to cause localized tissue death.