Percutaneous transmyocardial revascularization marking system

DETAILED DESCRIPTION What is claimed is: 1.
A method of marking a percutaneous transmyocardial revascularization channel comprising: inserting a catheter into a chamber of a heart of a patient; applying tissue ablative energy through said catheter to create a channel into the heart wall and then introducing to the heart wall proximate the channel for imaging; and viewing said imaging medium via an external imaging device positioned outside of said patient.
2.
The method of claim 1 further including aiming the catheter at a new position of the heart wall spaced from all previously marked channels, applying tissue ablative energy through said catheter to create another channel into said heart wall and introducing to the heart wall proximate that channel an imaging medium for marking the position of that channel.




Description:
FIELD OF INVENTION This invention relates to a percutaneous TMR channel marking system and method.
BACKGROUND OF INVENTION Transmyocardial revascularization (TMR) is presently accomplished using a laser to create channels in the wall of the left ventricle of the heart to perfuse the ischemic myocardium, thereby supplying blood and oxygen directly to the heart muscle, instead of installing one or more bypasses or using angioplasty to overcome blocked arteries and reinstate adequate blood flow.
In one approach a CO.
sub.
2 laser is used to create channels from the outside of the heart wall to the inside.
The channels heal rapidly on the outside, from digital pressure applied to the outside surfaces, leaving blind channels extending from the inside part way through the heart wall.
During surgery the surgeon can see each channel and carefully choose subsequent channel sites with correct spacing between them and avoid the danger of cutting a new channel too close to an existing one.
In another approach a Holmium or excimer laser supplies energy through a fiber optic element in a catheter to the inside of the left ventricle where channels are created in the heart wall from the inside toward but hopefully never reaching the outside of the wall: unlike channels cut from the outside in using a CO