Robot-assisted real-time magnetic resonance image-guided transcatheter aortic valve replacement

The Journal of Thoracic and Cardiovascular Surgery
Justin G MillerKeith A Horvath

Abstract

Real-time magnetic resonance imaging (rtMRI)-guided transcatheter aortic valve replacement (TAVR) offers improved visualization, real-time imaging, and pinpoint accuracy with device delivery. Unfortunately, performing a TAVR in a MRI scanner can be a difficult task owing to limited space and an awkward working environment. Our solution was to design a MRI-compatible robot-assisted device to insert and deploy a self-expanding valve from a remote computer console. We present our preliminary results in a swine model. We used an MRI-compatible robotic arm and developed a valve delivery module. A 12-mm trocar was inserted in the apex of the heart via a subxiphoid incision. The delivery device and nitinol stented prosthesis were mounted on the robot. Two continuous real-time imaging planes provided a virtual real-time 3-dimensional reconstruction. The valve was deployed remotely by the surgeon via a graphic user interface. In this acute nonsurvival study, 8 swine underwent robot-assisted rtMRI TAVR for evaluation of feasibility. Device deployment took a mean of 61 ± 5 seconds. Postdeployment necropsy was performed to confirm correlations between imaging and actual valve positions. These results demonstrate the feasibility of robotic-...Continue Reading

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Citations

Feb 3, 2016·The Journal of Thoracic and Cardiovascular Surgery·Amalia WintersVinod H Thourani
Mar 8, 2017·European Journal of Radiology·Soo Jung Kim, Kyung Ah Kim
Jun 21, 2018·Annals of Biomedical Engineering·Reza MonfarediKarun Sharma
Dec 30, 2020·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·John P CarneyRichard W Bianco

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