Аннотация:The paper presents the description of a high-power waveguide single-mode CO2 laser generating 800 W average beam power and up to 1 kW peak power at pulse duration from 2 to 100 ms. The diffusion-cooled active medium is excited by a capacitive AC discharge of sound frequency. The advantages of the laser are: High (> 10%) technical efficiency, upgraded stability of beam parameters at the cost of the use of waveguide generation mode, extremely low (< 1 nl/h) consumption of lasing mixture and possibility of operation in quasi-sealed-off regime; design simplicity, compactness and low cost. As an example of application of various capabilities of these lasers, a description of the developed medical system "Genom-4" used in the transmyocardial revascularization (TMR) procedure is presented. The system is equipped with devices which are necessary both to conducting biophysical experiments and to performing operations under clinical conditions; among them are computer control system, cardiograph for synchronization of laser pulse with ECG of the heart under operation, remote articulated mirror manipulator with optical hand-piece for performing operations...