Ultrasound Servoing of Catheters for Beating Heart Valve Repair

Abstract

Robotic cardiac catheters have the potential to revolutionize heart surgery by extending minimally invasive techniques to complex surgical repairs inside the heart. However, catheter technologies are currently unable to track fast tissue motion, which is required to perform delicate procedures inside a beating heart. This paper presents an actuated catheter tool that compensates for the motion of heart structures like the mitral valve apparatus by servoing a catheter guidewire inside a flexible sheath. We examine design and operation parameters and establish that friction and backlash limit the tracking performance of the catheter system. Based on the results of these experiments, we implement compensation methods to improve trajectory tracking. The catheter system is then integrated with an ultrasound-based visual servoing system to enable fast tissue tracking. In vivo tests show RMS tracking errors of 0.77 mm for following the porcine mitral valve annulus trajectory. The results demonstrate that an ultrasound-guided robotic catheter system can accurately track the fast motion of the mitral valve.