摘要:
Apparatus for treating a patient's heart by stimulating revascularization of the heart or creating channels in the heart. The apparatus includes a catheter, a laser energy source coupled to the catheter, and a control circuit. The control circuit is configured to cause the laser energy source to deliver an output of laser energy over a first time period shorter than a heart beat cycle.
摘要:
A novel enhanced flow metering device is adapted for disposing into a flow material reservoir a known volume of flow material whereby software used in conjunction with a pressure sensor may be calibrated. Additionally, by measuring the known amount of flow material returning to the flow material reservoir, checks are quickly made to ensure the pressure sensor is behaving as expected.
摘要:
An apparatus for treatment of body tissue includes a treatment apparatus configured to be inserted into a patient. The treatment apparatus has a distal portion, a distal end, a proximal portion and an axis. An ultrasound transducer is positioned at the distal portion of the treatment apparatus. The ultrasound transducer includes a distal ultrasound energy delivery surface and a proximal ultrasound energy delivery surface. An ultrasound energy attenuator member is positioned adjacent to the proximal ultrasound energy delivery surface and is made of a material to at least partially attenuate ultrasound energy from the proximal ultrasound energy delivery surface.
摘要:
A steerable percutaneous catheter for guiding at least one functional device to selected surfaces of a body for treatment thereon, particularly adapted for laser-assisted Percutaneous Transmyocardial Revascularization (PTMR). The steerable catheter has a handle portion at its proximal end and a controllably deflectable end portion at its distal end. The distal end of the catheter and the distal end of the functional device maintain alignment automatically during deflection. The invention also includes a surface contact detection system to detect contact with an interior body surface, such as the heart wall.
摘要:
A method of selecting laser parameters for performing laser-assisted myocardial revascularization to avoid inducing undesired cardiac arrhythmia without synchronization of delivery of laser energy and the patient's cardiac cycle, the method comprising the steps of minimizing the power level of laser energy used, thereby decreasing the overall trauma to the heart, selecting a pulse frequency as great as possible while avoiding adverse summation effects, selecting a pulse width as wide as possible to prevent excessively high peak powers per pulse and not so wide as to cause undesired thermal damage, selecting an energy flux rate, shaping the front end of each pulse of laser energy to provide efficient, non-explosive TMR channeling, and correcting the selected power level, pulse width, pulse frequency and energy flux rate for mechanical events, including method of access to the heart, position of selected portions of myocardium in the heart, temporal duration of the procedure, natural movement of the heart, specific heart geometry, pre-existing heart arrhythmia and other factors causing a predisposition to heart arrhythmia. A method for performing laser-assisted transmyocardial revascularization (TMR) and percutaneous transluminal myocardial revascularization (PTMR) using such laser energy with parameters selected to avoid inducing undesired cardiac arrhythmia, the method comprising the steps of generating laser energy having a predetermined non-square wave shape, a predetermined wavelength, a predetermined energy flux and a predetermined power level, and delivering the laser energy in a plurality of pulses, the plurality of pulses having a predetermined pulse frequency and a predetermined pulse width, to selected portions of myocardium to form TMR and PTMR channels without synchronizing delivery of the laser beam with the cardiac cycle.
摘要:
Systems and methods locate at least three spaced apart sensing units in association with volume of blood comprising a first blood component region, a second blood component region, and an interface region between the first and second blood component regions. The systems and methods locate at least one of the sensing units so that its optical field lies above the interface region and at least one of the sensing units so that its optical field lies below the interface region. Each sensing unit senses the attenuation of energy emitted into blood in its optical field and generates a signal relating to the attenuation. The systems and methods convert the signals to a signal vector of signal values having a shape approximated by a function. The systems and methods normalize the signal vector, and also create a vector of convolution signal values by multiplying the normalized signal vector by the function. The systems and methods identify the sensing unit associated with the highest convolution signal value. It is this sensing unit that lies closest to the interface. The systems and methods can limit the signal values of the signal vector according to prescribed criteria that eliminate the effect of noise.
摘要:
A catheter system with an outer catheter body defining at least one lumen and an inner catheter body defining at least one lumen with proximal and distal portions. An introducer is coupled to the distal portion of the inner catheter body. The introducer has a tissue piercing distal end. A resistive heater element is positioned in the introducer. The outer catheter is introduced into a patient's vasculature. The inner catheter is then introduced through the lumen of the outer catheter to a selected heart site. The tissue piercing distal end of the introducer is then advanced into an interior of the heart at the selected heart site. Energy is delivered to the selected heart site from the resistive heater element to create a blood conducting pathway and/or stimulate angiogenesis. In an alternative embodiment, a heart treatment apparatus includes a handpiece with a proximal and a distal end and an elongated member defining at least one lumen coupled to the handpiece distal end. The elongated member has a distal end and an introducer coupled to the distal end. The introducer has a tissue piercing distal end. A resistive heater element is positioned in the introducer. The tissue piercing distal end is introduced through a port in the chest wall into a chest cavity and through an epicardial surface of the heart wall to a selected site within the heart. Energy is delivered to the selected heart site from the resistive heater element to create a blood conducting pathway and/or stimulate angiogenesis.
摘要:
A method for improving blood flow in the heart provides a catheter system with an outer catheter defining at least one lumen and an inner catheter defining at least one lumen with proximal and distal portions. An introducer is coupled to the distal portion of the inner catheter. The introducer has a tissue piercing distal end. A resistive heater element is positioned in the introducer. The catheter system is introduced into a patient's vasculature. The inner catheter is then introduced through the a lumen of the outer catheter to a selected heart site. The tissue piercing distal end of the introducer is then advanced into an interior of the heart at the selected heart site. Energy is delivered to the selected heart site from the resistive heater element to create a blood conducting pathway and/or stimulate angiogenesis. In an alternative embodiment, a heart treatment apparatus is provided that includes a handpiece with a proximal and a distal end and an elongated member defining at least one lumen coupled to the handpiece distal end. The elongated member has a distal end and an introducer coupled to the distal end. The introducer has a tissue piercing distal end. A resistive heater element is positioned in the introducer. The tissue piercing distal end is introduced through a port in the chest wall into a chest cavity and through an epicardial surface of the heart wall to a selected site within the heart. Energy is delivered to the selected heart site from the resistive heater element to create a blood conducting pathway and/or stimulate angiogenesis.
摘要:
A novel enhanced flow metering device is adapted for disposing into a flow material reservoir a known volume of flow material whereby software used in conjunction with a pressure sensor may be calibrated. Additionally, by measuring the known amount of flow material returning to the flow material reservoir, checks are quickly made to ensure the pressure sensor is behaving as expected.
摘要:
A catheter tracking system for visualization of fluoroscopic images, the system comprising a fluoroscope for generating fluoroscopic image data, a fluoroscopic image visualization monitor, a catheter having an elongated shaft, particularly an intraventricular catheter, distal tip and a radio opaque portion adjacent the distal tip. A circumferential radio opaque band may be used to determine the relative position, orientation and motion of the catheter. An image analysis system capable of analyzing the image of the catheter and the radio opaque band, for receiving fluoroscopic image data from the fluoroscope determining physical parameters related to the left ventricle, and the relative position, orientation and motion of the catheter therein, and for determining the location and other parameters of treatment on intraventricular surfaces.