Design and Evaluation of a Dual-Bendable, Compressible Robotic Guide Sheath for Heart Valve Interventions

Structural heart interventions require precise navigation through tortuous and dynamic cardiac anatomies. However, current guide sheaths often lack sufficient maneuverability for positioning additional catheters. To address these limitations, this paper presents the design and evaluation of a robotic guide sheath with a dual-bendable, compressible tip. The sheath is capable of navigating complex cardiac anatomies for multiple valve interventions. The system consists of a soft continuum sheath tip driven by tendons, a laser-cut compact motorized actuation bed, and a joystick-controlled tendon actuation mechanism. A constant-curvature kinematic model maps actuation inputs to tip bending in 3D, while a custom software interface enables real-time control. Mechanical evaluation (tension, maximum bending, and contraction tests) demonstrated low actuation tension requirements (0.78 N), a wide bending range (from 80° to 90°), and promising tip compressibility (average 5 mm). Trajectory-following tests showed good accuracy, with an average error of 3.34 mm. Catheter guidance trials further validated the sheath’s ability to navigate to the right atrium and guide additional catheters effectively. This work presents a proof-of-concept robotic guide sheath with enhanced maneuverability and adaptability, establishing a foundation for future integration of sensing, automation, and clinical applications.