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    Method for non-synchronous laser-assisted transmyocardial revascularization
    4.
    发明授权
    Method for non-synchronous laser-assisted transmyocardial revascularization 失效
    非同步激光辅助心肌血运重建方法

    公开(公告)号：US5785702A

    公开(公告)日：1998-07-28

    申请号：US729325

    申请日：1996-10-15

    申请人： Douglas R. Murphy-Chutorian ,  Stuart D. Harman

    发明人： Douglas R. Murphy-Chutorian ,  Stuart D. Harman

    IPC分类号： A61B17/00 ,  A61B18/24 ,  A61B17/36

    CPC分类号： A61B18/24 ,  A61B2017/00247 ,  A61B2017/00703 ,  A61B2018/00392

    摘要： A method of selecting laser parameters for performing laser-assisted transmyocardial revascularization (TMR) 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) 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 channels in myocardium without synchronizing delivery of the laser beam with the cardiac cycle.

    摘要翻译： 选择用于执行激光辅助心肌血运重建（TMR）的激光参数以避免诱导不期望的心律失常而不发送激光能量和患者的心动周期的方法，所述方法包括以下步骤：最小化所使用的激光能量的功率水平， 从而减少对心脏的整体创伤，尽可能地选择脉冲频率，同时避免不利的相加效应，尽可能选择尽可能宽的脉冲宽度，以防止每脉冲过高的峰值功率，而不会导致不希望的热损伤， 选择能量通量速率，对激光能量的每个脉冲的前端进行整形，以提供有效的非爆炸性TMR通道，并校正机械事件的选定功率电平，脉冲宽度，脉冲频率和能量通量率，包括访问 心脏，心脏中选定部分心脏的位置，手术的持续时间， 心脏的自然运动，特定的心脏几何形状，预先存在的心律失常等导致心律失常倾向的因素。 一种使用这样的激光能量进行激光辅助心肌血运重建（TMR）的方法，所述激光能量选择为避免诱发不期望的心律失常，所述方法包括以下步骤：产生具有预定非方波形状，预定波长，预定波长的激光能量 能量通量和预定的功率水平，并且将多个脉冲具有预定的脉冲频率和预定的脉冲宽度的激光能量输送到心肌的选定部分以在心肌中形成TMR通道而不同步输送 激光束与心动周期。

    Combined mechanical/optical system for transmyocardial revascularization
    8.
    发明授权
    Combined mechanical/optical system for transmyocardial revascularization 失效
    用于经心肌血运重建的组合机械/光学系统

    公开(公告)号：US5713894A

    公开(公告)日：1998-02-03

    申请号：US607782

    申请日：1996-02-27

    申请人： Douglas Murphy-Chutorian ,  Stuart D. Harman

    发明人： Douglas Murphy-Chutorian ,  Stuart D. Harman

    IPC分类号： A61B18/20 ,  A61B17/00 ,  A61B18/24 ,  A61N5/06

    CPC分类号： A61B18/245 ,  A61B2017/00247 ,  A61B2018/00392

    摘要： The method for combined mechanical/laser myocardial revascularization of a human heart includes: inserting a mechanical piercing device and an elongated flexible lasing apparatus into the chest cavity of a patient; mechanically piercing, micro-tearing or spreading the epicardium of the heart; and then lasing from beneath the epicardium through the myocardium. The apparatus is guided to an area exterior to a ventricle of the patient's heart, and the distal end of the optical fiber apparatus is placed internal to the exterior wall of the heart through an opening which has been created by mechanically piercing, micro-tearing or spreading the epicardium, so that the myocardium and not the epicardium is irradiated with laser energy to allow passage of said optical fiber distal end or said laser energy into the left ventricular cavity without causing a laser irradiation of the epicardium which might be a cause of operative bleeding and for better allowing the sealing of the epicardium after the apparatus is removed.

    摘要翻译： 人心脏联合机械/激光心肌血运重建的方法包括：将机械穿刺装置和细长的柔性激光装置插入患者的胸腔; 机械穿刺，微裂或散布心脏的心外膜; 然后通过心肌从心外膜下射出。 该装置被引导到患者心脏的心室的外部区域，并且光纤装置的远端通过开口被放置在心脏的外壁的内部，所述开口通过机械刺穿，微撕裂或 扩散心外膜，使得心肌而不是心外膜被激光能量照射以允许所述光纤远端或所述激光能量通过到左心室，而不引起激光照射心外膜，这可能是手术的原因 出血并且更好地允许在除去装置之后密封心外膜。

    Laser assisted drug delivery
    9.
    发明授权
    Laser assisted drug delivery 失效
    激光辅助药物输送

    公开(公告)号：US5925012A

    公开(公告)日：1999-07-20

    申请号：US773872

    申请日：1996-12-27

    申请人： Douglas Murphy-Chutorian ,  Richard L. Mueller ,  Stuart D. Harman ,  Steve A. Daniel ,  Larry Witham ,  Robert Lincoln Lathrop, III ,  Bruce Richardson

    发明人： Douglas Murphy-Chutorian ,  Richard L. Mueller ,  Stuart D. Harman ,  Steve A. Daniel ,  Larry Witham ,  Robert Lincoln Lathrop, III ,  Bruce Richardson

    IPC分类号： A61B17/00 ,  A61B18/24 ,  A61M1/00

    CPC分类号： A61B18/24 ,  A61B2017/00247 ,  A61B2018/00392

    摘要： A drug delivery apparatus for dispensing predetermined volumes of drug, drug solution or other substances into an opening, such as a TMR channel in the human heart, or other laser treated area within the human body, the apparatus consisting of a bifurcated needle with a laser inlet for guiding a laser delivery means, such as an optical fiber or fiber bundle, to adjacent a surface of the human heart or other body structure for creating an opening, such as a TMR channel, or other laser treated area thereon. A drug inlet is for receiving the drug and transmitting the drug to the TMR channel or other laser treated area. Optionally, a piercing tip and/or suction device assists in positioning the apparatus adjacent the tissue to be treated. Drug is dispensed by manually or automatically actuating a piston or syringe element. A method of use is also disclosed.

    摘要翻译： 用于将预定体积的药物，药物溶液或其它物质分配到诸如人心脏中的TMR通道或人体内的其它激光处理区域的开口中的药物递送装置，该装置由具有激光的分叉针 用于将诸如光纤或纤维束的激光传送装置引导到靠近人心或其他身体结构的表面以在其上形成诸如TMR通道或其他激光处理区域的开口。 药物入口用于接收药物并将药物传输到TMR通道或其他激光治疗区域。 可选地，刺穿尖端和/或抽吸装置有助于将装置定位在待处理组织附近。 通过手动或自动启动活塞或注射器元件来分配药物。 还公开了一种使用方法。

    Intraoperative myocardial device and stimulation procedure
    10.
    发明授权
    Intraoperative myocardial device and stimulation procedure 失效
    术中心肌装置及刺激程序

    公开(公告)号：US06620153B2

    公开(公告)日：2003-09-16

    申请号：US09854072

    申请日：2001-05-11

    申请人： Richard L. Mueller ,  Douglas Murphy-Chutorian ,  Stuart D. Harman

    发明人： Richard L. Mueller ,  Douglas Murphy-Chutorian ,  Stuart D. Harman

    IPC分类号： A61G1820

    CPC分类号： A61B18/24 ,  A61B2017/00172 ,  A61B2017/00247 ,  A61B2017/22074 ,  A61B2017/22077 ,  A61B2018/00392 ,  A61B2018/208

    摘要： An apparatus for stimulating revascularization of myocardium tissue in the ventricular wall of a human heart is disclosed. The apparatus includes means for moving the distal end of an optical fiber element forwardly through the epicardium of the heart and into the myocardium and emitting relatively low power bursts of laser energy from the distal end to form stimulus injury zones that promote capillary growth and tissue revascularization. Each penetration of the optical fiber element may produce multiple stimulus zones spaced radially from or in line with the axis of the optical fiber element. Apparatus for moving the optical fiber element and controlling the laser emissions in a predetermined manner is also disclosed.

    摘要翻译： 公开了一种用于刺激人心脏心室壁心肌组织血运重建的装置。 该装置包括用于将光纤元件的远端向前移动通过心脏心外膜并进入心肌的装置，并且从远端发射相对低功率的激光能量脉冲以形成促进毛细血管生长和组织血运重建的刺激性损伤区域 。 光纤元件的每次穿透可以产生与光纤元件的轴线径向间隔开或与光纤元件的轴线成间隔的多个刺激区域。 还公开了用于移动光纤元件并以预定方式控制激光发射的装置。