# Development of a Flexible Parallel Wire Robot for Epicardial Interventions

**Authors:** Aman Ladak, Johannes O. Bonatti, Roger J. Hajjar, Alaaeldin A. Shalaby, Cameron N. Riviere

PMC · DOI: 10.1002/rcs.70130 · The International Journal of Medical Robotics + Computer Assisted Surgery · 2026-01-06

## TL;DR

A flexible robot called HeartPrinter is developed to deliver gene therapy to the beating heart using a suction-based system and an introducer mechanism.

## Contribution

The novel contribution is the development and evaluation of HeartPrinter and its introducer mechanism for epicardial interventions.

## Key findings

- The introducer mechanism successfully positioned HeartPrinter on an artificial beating heart.
- Base positions and registration were calculated with errors under 4 and 2 mm, respectively.
- HeartPrinter's components demonstrated feasibility for operation on the heart.

## Abstract

HeartPrinter is a flexible parallel wire robot that adheres to the beating heart with vacuum suction at three bases. An injector head actuated by cables delivers gene therapy injections within the bounds of the bases. To deploy onto the epicardium, an introducer mechanism is required. On the heart, the robot's workspace and anatomical model registration to its pose are needed.

We present HeartPrinter's components and introducer mechanism, and assess them on an artificial beating heart. We evaluate accuracy for position determination of the bases and registering a three‐dimensional heart scan.

The introducer mechanism successfully positioned HeartPrinter, and the bases adhered to the beating heart. The base positions and registration were calculated accurately with errors under 4 and 2 mm.

The introducer mechanism can deploy HeartPrinter on the epicardium, and HeartPrinter's components can operate on the heart. Workspace determination and registration demonstrate feasibility as preliminary concepts.

## Full-text entities

- **Diseases:** arrhythmia (MESH:D001145), heart disease (MESH:D006331), heart failure (MESH:D006333), neurologic dysfunction (MESH:D009461), vessel damage (MESH:C536223), pericardial sac (MESH:D008476), CAD (MESH:C000719218), perforations (MESH:D057112), infection (MESH:D007239)
- **Chemicals:** Nitinol (MESH:C013616), nylon (MESH:D009757), US10736703B2 (-)
- **Species:** Homo sapiens (human, species) [taxon 9606], Adeno-associated virus (species) [taxon 272636]

## Full text

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## Figures

20 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12772424/full.md

## References

41 references — full list in the complete paper: https://tomesphere.com/paper/PMC12772424/full.md

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Source: https://tomesphere.com/paper/PMC12772424