Percutaneous intracardiac beating-heart surgery using metal MEMS tissue approximation tools

Area of Science:

• Medical Robotics
• Cardiovascular Surgery
• Biomedical Engineering

Background:

• Current methods for closing abnormal communication between heart atria often involve open-heart surgery.
• Minimally invasive catheter-based procedures on a beating heart offer reduced risk but may lack the efficacy of surgical closure.

Purpose of the Study:

• To develop an integrated robotic technique for effective closure of atrial septal defects.
• To combine the efficacy of surgical closure with the reduced risk of catheter-based procedures.

Main Methods:

• An integrated design approach for robot, tooling, and procedure was applied.
• A concentric tube robot was utilized for percutaneous access to the right atrium.
• A novel tissue approximation device, fabricated using metal microelectromechanical systems (MEMS), was deployed.

Main Results:

• The robotic technique successfully enabled percutaneous access and deployment of the closure device.
• The MEMS-based device was designed to match the robot's capabilities and replicate surgical suture benefits.
• Ex vivo and in vivo experiments demonstrated the effectiveness of the proposed approach.

Conclusions:

• The integrated robotic approach offers a promising solution for minimally invasive closure of atrial septal defects.
• This technique has the potential to achieve surgical closure efficacy with reduced patient trauma and risk.