Introducer Design Concepts for an Epicardial Parallel Wire Robot.

Background: Cardiac gene therapies lack effective delivery methods to the myocardium. While direct injection has demonstrated success over a small region, homogenous gene expression requires many injections over a large area. To address this need, we developed a minimally invasive flexible parallel wire robot for epicardial interventions. To accurately deploy it onto the beating heart, an introducer mechanism is required.

Methods: Two mechanisms are presented. Assessment of the robot's positioning, procedure time, and pericardium insertion forces are performed on an artificial beating heart.

Results: Successful positioning was demonstrated. The mean procedure time was 230 ± 7 seconds for mechanism I and 259 ± 4 seconds for mechanism II. The mean pericardium insertion force was 2.2 ± 0.4 N anteriorly and 3.1 ± 0.4 N posteriorly.

Conclusion: Introducer mechanisms demonstrate feasibility in facilitating the robot's deployment on the epicardium. Pericardium insertion forces and procedure times are consistent and reasonable.