Closed-chest surgery on the beating heart is one of the strong drives behind catheter development. Coronary artery balloon dilations form a golden standard, but complex cardiac catheter interventions are still rare. Main difficulties are the absence of vessel wall support, making it hard to position the catheter tip precisely, and the complex 3D shape of the ventricles requiring intricate catheter maneuvers that are impossible to carry out with existing designs. The added effect of blood flow and tissue motion caused by respiration and heartbeat makes it hard to use catheters for complex interventions such as mitral valve annuloplasty procedures, cardiac tissue resection, atrial septal defect closures and precision cardiac biopsies and transcatheter aortic-valve implantation (TAVI).
We will develop novel multi-steerable catheter technology to enable accurate positioning within a beating heart under electromechanically-assisted manual control by a clinician.
WP 1.3.1: Intuitive multi-steerable catheter designs (TUD)
PhD1 will perform research on novel and intuitive multi-steerable catheter designs based on the available dendritic cable-ring technology and human factors experience at TUD. The four-year planning progresses from the development and in-vitro testing stages to the first concept single-segmented steerable catheter designs allowing left/right and forward/backward tip motions without rotating the catheter shaft, to the inclusion of electro-mechanic controls and Fiber Bragg Grating sensors to measure shape, as well as multiple steering segments allowing complex 3D tip curvatures. A final -in-vitro evaluation will be carried out together with PhD2 on an isolated beating-heart model developed by industrial partner Hemolab.
WP 1.3.2: Semi-automatic precision control of catheter (UT)
PhD2 will perform research on semi-automatic methods to precisely control these catheters based on mechanics-based models, and real-time shared control techniques developed at UT, with the aim of maintaining, fine-tuning and adjusting the clinician’s input to facilitate fine positioning within the beating heart, e.g., by introducing virtual fixtures to avoid vulnerable structures. PhD2 will model the internal mechanical behavior of multi-steerable catheters based on the cable-ring mechanism; develop patient-specific pre-operative plans, models and control techniques for the first multi-steerable catheter prototypes in a static environment incorporating the catheter mechanics, and functional models of vessels and heart muscles; develop and test intra-operative control techniques for controlling multi-steerable catheters in a dynamic environment incorporating the effects of respiration, heart beat and blood flow; finally integrate pre-operative plans and intra-operative control, and carry out the in-vitro evaluation on the beating-heart model together with PhD1.