Towards the Development of a Robotic Transcatheter Delivery System for Mitral Valve Implant

Abstract

Mitral regurgitation is one of the most common heart diseases caused by ventricular dysfunction or anatomic abnormality of the mitral valve. The fundamental treatment for mitral regurgitation is to repair/replace the mitral valve through open-heart surgery which is risky and requires more time to recover or through minimally invasive approaches, which have significant challenges and limitations. Through the transcatheter approach, the mitral valve implant is minimally invasively delivered directly to the mitral valve and is clamped onto the leaflet to mitigate or prevent regurgitation. However, this procedure requires delicate manipulation of the catheter in a constrained space and remains a challenging problem. In this work, we present a robotically steerable cathether design for the transcatheter procedure to address mitral regurgitation. The proposed catheter consists of two bending joints, one torsion joint, and implant delivery module at the distal end of the robot. Kinematic models for each joint design are derived and compared with experimental results. Finally, we experimentally demonstrate the feasibility of the proposed catheter to navigate in a phantom heart model. In this demonstration, the bending joint was actuated by 75°, the torsion joint was actuated by 90° and the implant was pushed out by 1.8 mm to deliver the implant.