What is the clinical evidence from this study?

Study design: Other. Population: Mitral regurgitation. Intervention: MitraNav robotic system. Primary outcome: Maximum positional error in trajectory-following experiments.

What question did this study set out to answer?

This research aims to design and model MitraNav, a robotic system for enhanced catheter control during transseptal mitral valve replacement.

May 5, 20260 citations

MitraNav: Design and Modeling of a Robotic System for Transseptal Mitral Valve Replacement with Dock Catheter Task-Space Control.

WWWeizhao WangKing's College London ZTZhenguan TuKing's College London JCJiyu CaiKing's College London

Key Result

The MitraNav robotic system demonstrated the feasibility of direct tip control for dock-based transcatheter mitral valve replacement, achieving maximum positional errors of 2.38 to 2.53 mm in bench trials.

Key Points

This research aims to design and model MitraNav, a robotic system for enhanced catheter control during transseptal mitral valve replacement.
Developed the MitraNav robotic system based on an existing guide-sheath robot.
Implemented a two-segment bending model for mapping joint space to task space.
Utilized a two-stage control strategy including joint-space control and task-space control.
Direct tip control experiments showed maximum positional errors of 2.38 mm, 2.53 mm, and 2.46 mm in three trials.
Positional errors were within acceptable accuracy ranges for catheter-based cardiac interventions.

Structured PICO

Population

Robotic system testing environment (trajectory-following experiments)

Intervention

MitraNav robotic system for dock-based transcatheter mitral valve replacement (TMVR)

Outcome

Trajectory-following accuracy (positional errors)surrogate

The MitraNav robotic system demonstrates feasible direct tip control with acceptable positional accuracy for dock-based transcatheter mitral valve replacement.

Limitations

The current prototype requires manual reconfiguration when switching catheters.
Control accuracy could be improved by incorporating real-time intraoperative imaging.
Validation has been limited to bench testing and has not tested the influence of chordal entanglement or failure to adequately encircle the subvalvular apparatus.
Lack of in-vitro heart models and in-vivo studies to evaluate performance under physiological forces, tissue interaction, and dynamic cardiac motion.

Abstract

PURPOSE: Transcatheter mitral valve replacement (TMVR) is a promising therapy for reducing mitral regurgitation in select patients. Direct tip control of multi-segment catheters can simplify manipulation and enable precise, stable positioning. This paper introduces MitraNav, the first robotic system developed for dock-based TMVR, focusing on system design and task-space control of the dock catheter. METHODS: Built on a previously validated guide-sheath robot, MitraNav is upgraded to support concentric multi-catheter manipulation via a unified actuation mechanism. It suits both dock and balloon catheters, enabling all catheter manipulation using a single robotic system. A two-segment bending model maps joint space to task space through an intermediate configuration space. A two-stage control strategy is then applied: joint-space control allows for rapid approach to the mitral annulus, followed by task-space control for direct tip positioning. To improve accuracy and handle joint limits, the task-space controller incorporates Jacobian normalization to balance joint contributions, null-space optimization to regulate joint motion without affecting the primary task, and a PD controller to reduce tracking errors. RESULTS: Trajectory-following experiments demonstrate feasibility of direct tip control, with maximum errors of 2.38 mm, 2.53 mm, and 2.46 mm in three trials. These positional errors are within the range of acceptable accuracy commonly considered for catheter-based cardiac interventions. CONCLUSION: MitraNav represents the foundation for intuitive catheter manipulation and offers the potential for semi-autonomous robotic dock-based TMVR.

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