Performing surgery within the delicate environment of a beating heart has always posed significant challenges for surgeons.
However, a potential game-changer may be on the horizon, thanks to a robotic catheter developed by a team of physicians and engineers at Boston University.
This innovative device boasts shape-shifting capabilities that enable it to navigate complex cardiac anatomy while maintaining the necessary stability to accomplish surgical tasks within the heart.
In a groundbreaking study published in Science Advances, the researchers demonstrated the robot’s effectiveness by assisting with two simulated cardiac procedures using animal tissue.
They believe that with further refinement and development, this robotic catheter could greatly enhance the safety and ease of many common heart surgeries.
Moria Bittmann, Ph.D., Director of the NIBIB Robotics Program, commended the team’s design, emphasizing its careful consideration of patient safety.
She noted that the robotic catheter integrates various robotic features to navigate the challenging and risky cardiac surgical environment.
In the United States, a significant number of cardiac procedures still involve open-heart surgeries, which provide surgeons with high control but come with lengthy recovery periods and are not suitable for high-risk patients.
Less invasive methods involve threading catheters through the body’s vasculature to reach the heart.
However, these instruments, though small enough to navigate peripheral veins, struggle to contend with the movement of the beating heart, lacking the necessary dexterity for precise tissue targeting.
This conundrum has left researchers seeking an instrument with seemingly contradictory properties—small yet large, rigid yet maneuverable.
To tackle this challenge, senior author Tommaso Ranzani, Ph.D., a professor of mechanical engineering at Boston University, and his team designed a robotic system with adaptive properties for different phases of a procedure.
The robotic catheter features a flexible, air pressure-operated tip, slim enough to navigate veins and expandable once inside the heart.
To enhance stability, they incorporated an expandable ring that anchors the catheter in place against the vein walls near the heart’s entrance.
With both the stabilizing mechanism and inflatable tip, the researchers believed the catheter could exert enough force to penetrate beating heart tissue without getting pushed back.
Afterward, it could retract both the stabilizer and tip for an easy exit.
In realistic settings, the researchers tested the device by performing two cardiac procedures within the right atrium of a pig heart (ex vivo).
The first procedure, pacemaker lead placement, was completed by five inexperienced operators using the robotic catheter, and they did so in a similar time frame as an experienced physician using a standard catheter.
The second trial involved an initial step of a tricuspid valve repair procedure, a complex operation typically requiring open-heart surgery.
The robotic catheter, targeting a pulsating valve connected to a motor, successfully anchored a ring in a predetermined spot three times.
The researchers now plan to move on to live subjects and tackle more complex procedures, with the ultimate goal of reducing the need for taxing open-heart surgeries.
Ranzani expressed optimism about the technology’s potential, noting that discussions with physicians have revealed a growing enthusiasm and recognition of numerous applications for this innovative approach.
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The research findings can be found in Science Advances.
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