a method for performing transmyocardial revascularization comprises the steps of creating an incision in an outer portion of heart tissue of a patient and creating a channel in the patient &# 39 ; s myocardium through the incision by advancing a channel creating device into the myocardium beyond the depth of the incision to remove myocardial tissue without removing all outer portion heart tissue coinciding with the channel . as a result , the remaining outer portion tissue acts as a cap to reduce bleeding from the channel subsequent to removal of the channel creating device . the cap may be in the form of an annular flap of myocardial / epicardial tissue . the channel creating device used to create the channel with the method can be either a mechanical coring device or an advancing lasing device .