Femtosecond laser technology has emerged as an efficient therapeutic tool, demonstrating significant potential across various medical fields ([1], [2], [3], [4], [5], [6], [7], [8]). Compared to traditional nanosecond and picosecond lasers, femtosecond lasers deliver higher pulse energy and peak power while maintaining a narrow pulse width, enabling precise tissue excision with minimal thermal diffusion and collateral damage ([9], [10], [11]). These characteristics have led to the designation of femtosecond lasers as “cold machining” tools, which are widely utilized in minimally invasive surgery, lesion excision, and tissue engineering, significantly enhancing the precision and efficiency of tissue removal (12). Consequently, femtosecond laser technology is well-suited for the accurate incision of myocardial tissue, showing promising prospects for clinical applications. However, significant challenges remain in international research within this domain.

Early laser research in the field of cardiovascular medicine has primarily focused on laser-induced transmyocardial revascularization and endocardial ablation for cardiac arrhythmias ([13], [14], [15], [16], [17]). Currently, many cardiac conditions, such as hypertrophic obstructive cardiomyopathy, right ventricular outflow tract obstruction, cardiac tumors, and various intracardiac masses, necessitate the surgical excision of diseased myocardial tissue ([18], [19], [20]). Nevertheless, the removal of these tissues still relies on traditional surgical scalpels, with the success of the procedure largely dependent on the surgeon's expertise and dexterity. As a result, the potential of femtosecond laser technology for precise tissue excision beyond ophthalmological applications remains underexplored.

In recent years, significant advancements have been made in the mechanisms of action and incision characteristics of femtosecond laser technology in biological tissues (21). Research has demonstrated that femtosecond lasers generate extremely high energy densities through nonlinear optical phenomena, exhibiting superior performance in terms of incision depth, precision, and thermal damage control, thereby facilitating efficient tissue excision (10). These studies have encompassed the excision of brain, liver, and oral soft tissues ([22], [23], [24]). Although femtosecond lasers have been widely applied in fields such as ophthalmology, dermatology, and soft tissue surgery, their use in cardiac tissue presents distinct challenges and opportunities. The myocardium exhibits unique structural features—including anisotropic fiber orientation, intercalated discs, and high mitochondrial density—that significantly influence laser–tissue interactions. Moreover, laser parameters such as power and scanning speed critically affect incision depth, width, and thermal effects, necessitating precise optimization for cardiac applications.

We hypothesized that femtosecond lasers could achieve precise myocardial excision with optimal cutting outcomes, providing a novel option for minimally invasive myocardial surgery. Our research aimed to validate the clinical applicability and safety of utilizing 1064 nm femtosecond lasers for myocardial tissue excision through ex vivo animal studies. We investigated the effects of variations in cutting parameters associated with femtosecond laser technology on excision efficacy and the resulting pathological changes. This study seeks to establish a solid foundation for the clinical translation and eventual application of this technology in a clinical setting.