Continuum Robotic Catheter Systems for Transcatheter Mitral Valve Procedures: A Technical Review

Abstract

Transcatheter mitral valve procedures have transformed the treatment of mitral regurgitation and stenosis by providing less invasive alternatives to conventional open-heart surgery. However, they introduce stringent requirements for catheter navigation, force modulation, and real-time imaging in a highly dynamic cardiac environment. In this article, a comprehensive technical overview of continuum robotic catheter systems developed specifically for transcatheter mitral valve interventions is presented. Fundamental design principles of flexible, tendon-driven architectures are examined, highlighting their capacity to navigate tortuous vascular pathways and offer multi-degree-of-freedom control. The integration of advanced sensing technologies, real-time imaging methods, and intelligent control strategies is discussed. Clinical studies and in vivo validations are reviewed, underscoring critical performance metrics such as positional accuracy, procedural safety, and device miniaturization. Persistent challenges are also addressed, including limited high-fidelity data for machine learning, a lack of robust haptic feedback in delicate cardiac tissue manipulation, and regulatory hurdles for complex robotic platforms. Furthermore, emerging innovations in materials science, three-dimensional printing, and sensor fusion are explored, illustrating the potential for next-generation systems that enhance precision while reducing operator workload. Finally, key opportunities for future research are outlined, with an emphasis on personalized navigation algorithms, standardized evaluation protocols, and broader applicability in cardiovascular and endovascular procedures.