Aortic valve surgery is the preferred procedure for replacing a damaged valve with an artificial one. The ValveTech robotic platform comprises a flexible articulated manipulator and surgical interface supporting the effective delivery of an artificial valve by teleoperation and endoscopic vision. This article presents our recent work on force-perceptive, safe, semiautonomous navigation of the ValveTech platform prior to valve implantation. First, we present a force observer that transfers forces from the manipulator body and tip to a haptic interface. Second, we demonstrate how hybrid forward/inverse mechanics, together with endoscopic visual servoing, lead to autonomous valve positioning. Benchtop experiments and an artificial phantom quantify the performance of the developed robot controller and navigator. Valves can be autonomously delivered with a 2.0±0.5 mm position error and a minimal misalignment of 3.4±0.9°. The hybrid force/shape observer (FSO) algorithm was able to predict distributed external forces on the articulated manipulator body with an average error of 0.09 N. FSO can also estimate loads on the tip with an average accuracy of 3.3%. The presented system can lead to better patient care, delivery outcome, and surgeon comfort during aortic valve surgery, without requiring sensorization of the robot tip, and therefore obviating miniaturization constraints.
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http://dx.doi.org/10.1109/TRO.2023.3315966 | DOI Listing |
J Surg Res
December 2024
Division of Cardiac Surgery, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio. Electronic address:
Introduction: Transcatheter aortic valve replacement (TAVR) has become a viable alternative to surgical aortic valve replacement (SAVR) for high-risk patients with aortic stenosis. One such high-risk group is patients with pulmonary hypertension (PH), which is known to increase surgical risk and adversely affect outcomes. This study aims to compare midterm and long-term survival in TAVR and SAVR among patients with PH.
View Article and Find Full Text PDFBiomech Model Mechanobiol
December 2024
Institute for Biomedical Engineering and Nano Science, Shanghai East Hospital, Tongji University School of Medicine, 500 Zhennan Road, Shanghai, 200331, People's Republic of China.
Hypertension and bicuspid aortic valve (BAV) are key clinical factors that may affect local biomechanical properties of ascending thoracic aortic aneurysms (ATAAs). This study sought to investigate regional differences in biaxial mechanical properties of the ATAAs for the hypertensive patients with BAV. Fresh ATAA samples were harvested from 16 hypertensive patients (age, 66 ± 9 years) undergoing elective aortic surgery.
View Article and Find Full Text PDFRev Esp Cardiol (Engl Ed)
December 2024
Département de Cardiologie, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec, Canada. Electronic address:
Introduction And Objectives: The Valve Academic Research Consortium (VARC)-3 definition of the early safety (ES) composite endpoint after transcatheter aortic valve replacement (TAVR) lacks clinical validation. The aim of this study was to determine the incidence, predictors, and clinical impact of ES after TAVR as defined by VARC-3 criteria.
Methods: We performed a multicenter study including 10 078 patients with severe aortic stenosis undergoing transarterial TAVR.
JACC Cardiovasc Interv
December 2024
Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, RGDS (Ramsay Generale De Santé), Massy, France. Electronic address:
JACC Cardiovasc Interv
December 2024
Department of Cardiology, The Heart Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Background: Survival after transcatheter aortic valve replacement (TAVR) has markedly increased. Thus, other comorbidities will intersect patient trajectories and challenge follow-up.
Objectives: The aim of this study was to describe patient characteristics and hospitalizations at end of life to further improve the quality of life for patients undergoing TAVR.
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