Abstract:

Mitral regurgitation is a structural heart disease characterized by dysfunction of the mitral valve. It can be treated through minimally invasive transcatheter edge-to-edge repair procedures, such as those involving the MitraClip system. Despite its clinical efficacy, the procedure poses technical challenges, requiring interventional cardiologists to undergo multiple procedures to achieve instrumentation proficiency. Previous studies have demonstrated the efficacy of extended reality simulators in improving surgical skill training. The purpose of this study is to evaluate the effectiveness of visuo-haptic feedback within an extended reality simulator to accelerate and enhance the learning process for the MitraClip procedure, potentially offering a valuable tool in surgical training. In this study, based on the prototype of our previous simulator, we further implemented a novel cardiac dynamic environment, a visual feedback interface, an innovative haptic armband, and a new model of the catheter to enhance the simulator’s fidelity and educational usability. Experiment results demonstrated that users benefiting from visuo-haptic feedback exhibited significantly reduced completion times, reduced deviation from predefined trajectories, and presented safer navigation results. Moreover, users preferred the visuo-haptic feedback experience, highlighting its perceived value in enhancing training. These findings underscore the potential of adding visuo-haptic feedback to extended reality simulators in surgical training for complex procedures, improving proficiency and patient surgery outcomes.

Abstract:

Mitral regurgitation is a structural heart condition affecting the mitral valve that can be treated with the MitraClip system ™, a device that allows a percutaneous intervention for the deployment of a catheter-embedded clip on the valve leaflets to prevent blood-backflow from the left ventricle to the left atrium. Despite its efficacy, the procedure presents technical challenges, relying on fluoroscopy guidance and surgeon expertise. In the context of human-machine interface for autonomous robotic catheter cardiac intervention, this study aims to evaluate the effectiveness of Augmented Reality (AR) for training surgeons in the MitraClip procedure. Users using an AR Interface demonstrated better performance compared to those using an interface emulating traditional visualization methodologies (fluoroscopy and transesophageal echocardiogra-phy). AR-based training offers a more engaging and effective learning experience, leading to improved surgical dexterity and safety in the procedure.