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International Journal of Computer Assisted Radiology and Surgery

Erschienen in:

01.10.2016 | Original Article

Robotic-assisted real-time MRI-guided TAVR: from system deployment to in vivo experiment in swine model

verfasst von: Joshua L. Chan, Dumitru Mazilu, Justin G. Miller, Timothy Hunt, Keith A. Horvath, Ming Li

Erschienen in: International Journal of Computer Assisted Radiology and Surgery | Ausgabe 10/2016

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Abstract

Purpose

Real-time magnetic resonance imaging (rtMRI) guidance provides significant advantages during transcatheter aortic valve replacement (TAVR) as it provides superior real-time visualization and accurate device delivery tracking. However, performing a TAVR within an MRI scanner remains difficult due to a constrained procedural environment. To address these concerns, a magnetic resonance (MR)-compatible robotic system to assist in TAVR deployments was developed. This study evaluates the technical design and interface considerations of an MR-compatible robotic-assisted TAVR system with the purpose of demonstrating that such a system can be developed and executed safely and precisely in a preclinical model.

Methods

An MR-compatible robotic surgical assistant system was built for TAVR deployment. This system integrates a 5-degrees of freedom (DoF) robotic arm with a 3-DoF robotic valve delivery module. A user interface system was designed for procedural planning and real-time intraoperative manipulation of the robot. The robotic device was constructed of plastic materials, pneumatic actuators, and fiber-optical encoders.

Results

The mechanical profile and MR compatibility of the robotic system were evaluated. The system-level error based on a phantom model was 1.14 ± 0.33 mm. A self-expanding prosthesis was successfully deployed in eight Yorkshire swine under rtMRI guidance. Post-deployment imaging and necropsy confirmed placement of the stent within 3 mm of the aortic valve annulus.

Conclusions

These phantom and in vivo studies demonstrate the feasibility and advantages of robotic-assisted TAVR under rtMRI guidance. This robotic system increases the precision of valve deployments, diminishes environmental constraints, and improves the overall success of TAVR.

Vorheriger Artikel Accuracy evaluation of a mitral valve surgery assistance system based on optical tracking

Nächster Artikel Skull reconstruction after resection of bone tumors in a single surgical time by the association of the techniques of rapid prototyping and surgical navigation

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Titel: Robotic-assisted real-time MRI-guided TAVR: from system deployment to in vivo experiment in swine model
verfasst von: Joshua L. Chan
Dumitru Mazilu
Justin G. Miller
Timothy Hunt
Keith A. Horvath
Ming Li
Publikationsdatum: 01.10.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: International Journal of Computer Assisted Radiology and Surgery / Ausgabe 10/2016
Print ISSN: 1861-6410
Elektronische ISSN: 1861-6429
DOI: https://doi.org/10.1007/s11548-016-1421-4

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Abstract

Purpose

Methods

Results

Conclusions

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