Using Robotics to Improve Transcatheter Edge-to-Edge Repair of the Mitral Valve

Transcatheter valve repair presents significant challenges due to the mechanical limitations and steep learning curve associated with manual catheter systems. This paper investigates the use of robotics to facilitate transcatheter procedures in the context of mitral valve edge-to-edge repair. Specifically, the study builds upon the MitraClip^™ (Abbott, USA), a widely used commercial system for mitral valve repair, adapting it for robotic actuation to evaluate potential performance improvements. The complex handle-based control of a clinical repair device is replaced by intuitive robotic joint-based control via a game controller. Manual versus robotic performance is analyzed by decomposing the overall device delivery task into motion-specific steps and comparing capabilities on a step-by-step basis in a phantom model of the heart and vasculature. Metrics include procedure duration and clip placement accuracy. Results demonstrate that the robotic system can reduce procedural time and motion errors while also improving accuracy of clip placement. For the most commonly treated middle leaflet segment, mean delivery time is reduced from 146.6sec to 76.2sec while mean clip positioning error is reduced from 3.1mm to 0.6mm. These findings suggest that robotic assistance can address key limitations of manual systems, offering a more reliable and user-friendly platform for complex transcatheter procedures.