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Robotic cardiac surgery to be performed using MR within an MRI

Scientists at Case Western Reserve University (CWRU) are putting the pieces together for the first surgery to manage stroke risk in people with atrial fibrillation (AFib).

A group of researchers from Case Western Reserve University (CWRU) has been awarded a multiple-year grant worth $3.7 million from the National Institutes of Health to try something they claim would be a first in medicine. They will be using the funding to work on successfully performing a robotic heart catheterisation procedure while the patient is in an MRI machine.

In order to attain unmatched surgical precision, a doctor operating a micro-robotic instrument would carry out the treatment whilst donning a mixed reality (MR) headset. The procedure to be carried out is a Left Atrial Appendage Occlusion (LAAO). Its intended outcome is to reducestroke risk in patients with atrial fibrillation (AFib).

Based on the information provided by the Centers for Disease Control, AFib is the most prevalent type of heart arrhythmia. It has affected between 3 and 6 million Americans according to some estimates. According to the NIH, heart arrhythmia, which is also commonly referred to as an irregular heartbeat, is primarily a problem concerning one’s heart rhythm and rate. Those affected by this condition may witness their heart beating too fast or too slow.

To deliver an implant that lessens blood clots in one’s heart leading to strokes in Afib patients, surgeons thread a tube known as the catheter up to one’s heart through either an artery or a vein in the groin area.

The doctor uses a cardiac X-ray, which provides a significantly blurry visual of the heart. They use this to manually insert the heart implant whilst viewing the heart tissue using conventional methods.

Cenk Cavusoglu, the principal investigator and director of the Case School of Engineering’s Medical Robotics and Computer-Integrated Surgery (MeRCIS) Lab, is a professor of electrical, computer, and systems engineering. He remarked about the MR endeavour saying that with the aid of the institution’s technology, doctors could view real-time, clinical-grade images of soft tissues. The micro-robot would carry out the surgery after being able to locate it appropriately. As a result, the method would be cleaner, quicker, much more successful, and more inexpensive when used to address atrial fibrillation (AFib).

The researchers seek to improve the accessibility of AR-guided surgical techniques for AFib patients, particularly those whose life expectancy is longer than two decades, by showcasing the advantages of this procedure.

The robotic catheter within the MRI, along with the agile MRI imaging, according to Cavusoglu, both present considerable obstacles. It took a team effort from multiple subject matter experts to unite them.

Cavusoglu is collaborating with former bioengineering coworker Nicole Seiberlich, who is currently with the University of Michigan, and radiology professor Mark Griswold from the Case Western Reserve School of Medicine. Other associates were Joseph Piktel from MetroHealth, Mauricio Arruda from University Hospitals Cleveland Medical Center, and Hiram Bezerra from the University of South Florida.

Using the same technology, Cavusoglu and his colleagues were awarded a previous NIH grant a few years back to create a system for performing MRI-assisted robotic afib ablation.

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