Accurate clip positioning (including position, direction, and orientation) in transcatheter mitral edge-to-edge repair (M-TEER) is challenging due to the complexity of manipulating tendon-driven concentric catheters under imaging guidance. Existing methods are limited to either task-space position/shape control or image-space joint control. This study presents a compact eight-DoF robot for controlling the PASCAL device, achieving closed-loop pose control in image space. Building on a prior variable curvature model, we develop a kinematic model that accounts for coupling between catheter handles and compensates for tip length variation. A prior sheath shape model is also integrated to support safer navigation in confined anatomy during clip adjustment. To achieve precise image-space pose control, we design a novel framework featuring a mapping strategy for independent control of clip position, direction, and orientation relative to registered imaging views, along with a Jacobian-based PID controller. Simulation results demonstrate effective independent control, with only direction adjustments exhibiting minor coupling with orientation (maximum deviation: 2.69$^{\circ }$). Experiments show that closed-loop control effectively mitigates catheter misalignment and rubber deformation, achieving average positional and angular RMSEs to 0.52 mm and 0.61$^{\circ }$. This robot provides precise, image-space pose control, which is expected to assist with the challenge of accurate clip positioning in M-TEER.

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.