Stabilizing interventional instruments in the cardiovascular system: A classification of mechanisms.

Positioning and stabilizing a catheter at the required location inside a vessel or the heart is a complicated task in interventional cardiology. In this review we provide a structured classification of catheter stabilization mechanisms to systematically assess their challenges during cardiac interventions. Commercially available, patented, and experimental prototypes of catheters were classified with respect to their stabilizing mechanisms.

First Expert Evaluation of a New Steerable Catheter in an Isolated Beating Heart.

Purpose: In previous studies we developed two mechanical prototypes of steerable catheters: the Sigma, which uses joysticks to actuate two steerable tip segments, and the Epsilon, which has a handle that is an enlarged version of the tip. In this study, we present a first performance evaluation of the prototypes in the cardiac environment. The evaluation was carried out by an expert user, an electrophysiologist with over 20 years of experience, to obtain insight in clinically relevant factors.

Catheter steering in interventional cardiology: Mechanical analysis and novel solution.

In recent years, steerable catheters have been developed to combat the effects of the dynamic cardiac environment. Mechanically actuated steerable catheters appear the most in the clinical setting; however, they are bound to a number of mechanical limitations. The aim of this research is to gain insight in these limitations and use this information to develop a new prototype of a catheter with increased steerability.

ChoRe: A device for trans-catheter chordae tendineae repair.

This work focuses on the design of a new device (called ChoRe) to place artificial chords in the mitral valve structure during a trans-catheter procedure. The aim of the device is to restore the correct functionality of the valve and solve mitral valve regurgitation, that is, a common consequence of chordae tendineae rupture. An analysis of the requirements was carried out and used to design and develop a first functional prototype.

Steerable Catheters in Cardiology: Classifying Steerability and Assessing Future Challenges.

Objective: This review aims to provide a structured classification of the underlying steering mechanisms in steerable catheters and to assess their future challenges.

Methods: Existing, patented, and experimental designs of steerable catheters are classified with respect to their steerability. Subsequently, the classification is used as a tool for defining future requirements and challenges for steerable cardiac catheters.