Cardiac interventions under MRI guidance using robotic assistance

Transapical aortic valve replacement under MRI guidance in a beating heart is a recent minimally invasive technique that could benefit from a surgical assistant system. We present a robotic surgical assistant system that can precisely and repeatably deliver aortic valve prostheses. The surgical system consists of an imaging system, an Innomotion robotic arm, a 3-DoF valve delivery module and user interfaces. Interactive control allows the physician to remain in the loop and adjust the orientation and position using real-time MR feedback. The 3-DoF valve delivery module is developed to deploy both balloon-expandable and self-expanding stented prostheses. We use a new compact fiducial that can be placed close to the volume of interest and requires a single image plane for image based robot registration. We evaluate the MRI compatible valve delivery module for both types of prostheses. The accuracy for prosthesis delivery is about 0:8 mm and 1:5 mm, for self-expanding and balloon-expandable prostheses, respectively. Preliminary results in ex-vivo experimentation suggest that the robotic system can be translated into animal and clinical models.