The HeartLander: A novel epicardial crawling robot for myocardial injections

Abstract

Myocardial infarction is the leading cause of congestive heart failure and death in the industrialized world. Stem cell transplantation to failing myocardium appears to improve heart function following myocardial infarction, but further refinement of the delivery methodology is required. The HeartLander miniature mobile robot has the ability to adhere to the epicardium, travel to the operative site, and perform intramyocardial injections under direct control of the surgeon. This paradigm obviates sternotomy, cardiopulmonary bypass, mechanical stabilization and lung deflation, while granting improved access. To facilitate movement under the pericardium, a small prototype with a tapered front has been constructed that is 11 mm tall and fits through a 15-mm cannula. This prototype was tested in beating-heart porcine trials via median sternotomy, but with the pericardium intact ( N = 2). The HeartLander was able to maintain prehension and travel without being displaced by the overhead motion of the pericardium. Myocardial injections of tissue dye were performed successfully at several locations. These experiments show the feasibility of navigating under the pericardium and performing needle injections into the myocardium using video feedback. Future research will move toward minimally invasive testing without sternotomy, including both locomotion and therapy.