Robot Catheter Eases Mitral Valve Heart Surgery

The heart’s mitral valve keeps blood from the lungs pumping in the right direction. When the valve fails to close tightly, blood flows back toward the lungs with every heartbeat—the wrong direction. This is called mitral regurgitation (MR). While some patients with MR feel just fine, if the valve continues to fail or becomes even less competent, patients begin to feel tired and breathless. If untreated, they can die.

Up to 2 million Americans develop moderate to severe MR every year. MR complications tend to occur in people who are older and have other heart-related problems but can happen in younger people, too. MR usually is treated by open heart surgery or by a less-invasive transcatheter edge-to-edge repair (TEER) procedure, which can be difficult to learn and to perform. This can lead to poor outcomes if the surgery is particularly challenging or if the surgeon is inexperienced.

However, TEER therapy is still a great option. Unfortunately, it works best when performed by a specialist who has performed over 200 procedures and who is working at a large-volume TEER “center of excellence.”

Biotech Moray Medical of Mountain View, California, has developed a new process to make TEER operations easier to perform. Their system uses a robotic catheter, augmented reality and a 3D digital interface to simplify cardiac procedures such as TEER so that surgeons will have the best chance of performing a successful operation. Moray Medical was a candidate for the 2020 MedTech Innovator Grand Prize for the system.

According to Mark Barrish, cofounder and CEO of Moray Medical, 2% of MR patients are treated with surgery, either open-heart surgery or robotically assisted laparoscopic surgery. Such surgeries can be dangerous for patients and difficult for doctors and can require long recovery times. For TEER, a less invasive option, a TEER implant (clip) is wound through the blood vessels and into the heart on the end of a heart catheter. With the help of ultrasound and fluoroscopic images, the cardiologist then has to move the clip within the heart to a place where it can be used to permanently clip shut the leaky parts of the mitral valve.

Moray Medical has developed a fluid-driven robotic catheter system (which includes the Clipper TEER implant, Subsmersion virtual reality environment, Coral fluidic driver and Trident input device) that makes this process far easier, by allow the doctor to see what he or she is doing more easily during the procedure through a 3D computer interface. The clip is placed by touching the computer rather than manipulating instruments by hand. Barrish says that  interaction with the Moray system is easier to learn and more precise than conventional TEER. Rather than having to look at many separate images to guide the clip into place, a doctor using the Submersion virtual reality environment instead sees real-time images aligned in a 3D robotic workspace that contains a virtual model of the Clipper robotic TEER system. This helps the cardiologist know the location of the implant and how to move it more easily. Procedures with the Moray TEER system usually take less time as well.

Disclaimer: This article does not provide medical advice. Do not take action based solely on this article and always consult with an appropriate healthcare professional. This article is purely for informational purposes.

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