World's First Cross-Border Remote Robot-Assisted Cardiac Intervention Completed in Xiamen

Background

The Affiliated Cardiovascular Hospital of Xiamen University has been at the forefront of robotic technology in cardiovascular medicine. In 2023, the hospital completed the world's first robot-assisted transcatheter mitral valve edge-to-edge repair using a system co-developed with a Shanghai medical technology company possessing full independent intellectual property rights. This built experience with high-precision mechanical arms, intelligent motion control, adaptive safety algorithms and communication technology.

On October 23, 2025, the hospital achieved what multiple official Chinese media reports and the hospital describe as the world's first cross-border remote robot-assisted cardiac intervention. Chinese and French experts collaborated via a remote control platform. Professor Wang Yan, president of the hospital, was at the University Hospital of Bordeaux in France during the procedure.

What was achieved

Working alongside Professor Lionel Leroux, head of the adult structural heart disease intervention department at Bordeaux University Hospital, with online guidance from Professor Thomas Modine, head of the structural valve disease treatment and innovation center, the team remotely operated the robotic system located in a catheterization laboratory in Xiamen. The patient was a 73-year-old male with severe mitral regurgitation associated with heart failure. The procedure spanned more than 10,000 kilometers over the Eurasian continent.

The operation lasted approximately one hour with stable high-speed, low-latency international network communication and sub-millimeter operational precision. No local operator manipulated instruments in the Xiamen lab. The Xiamen cardiac intervention, anesthesia, ultrasound and nursing teams monitored the patient's vital signs and system status in real time. The procedure achieved near-zero mitral regurgitation. The patient recovered well and was discharged.

How it works

Mitral regurgitation occurs when the mitral valve between the left atrium and left ventricle does not close tightly, allowing blood to leak backward and straining the heart, often leading to heart failure symptoms. TEER, or transcatheter edge-to-edge repair, is a minimally invasive catheter-based technique performed on the beating heart. A device is delivered via a catheter inserted through the femoral vein and guided using fluoroscopy and transesophageal echocardiography to the mitral valve, where it clips together the edges of the anterior and posterior leaflets to reduce the regurgitant jet without open-heart surgery.

In this remote robotic application, the domestically developed system in the Xiamen lab was controlled from France. Commands traveled via a high-speed, low-latency international network with 5G redundant communication, reported to maintain latency under 200 milliseconds. The robotic arms executed precise navigation, positioning and deployment of the clip with sub-millimeter accuracy on the moving heart. The technology integrates intelligent motion control and safety algorithms. Local Xiamen teams ensured overall stability while the remote operators directed the system.

What it means for international patients

The hospital has established an International Medical Center providing coordinated services for overseas patients, including one-stop care, international insurance arrangements and green channels for urgent cases. It has reported receiving over 400 patient visits from 33 countries in 2025 for cardiovascular conditions. The hospital also operates the Heart Sapling (Xinmiao) Visiting Scholar Program, which has trained physicians from more than a dozen countries, including participants from Belt and Road and BRICS nations.

This procedure demonstrates the hospital's capabilities in advanced structural heart interventions and remote robotic technology. International patients considering care for cardiovascular conditions at the facility should contact the hospital's International Medical Center directly to confirm eligibility, current service availability, documentation requirements and any specific arrangements for medical tourists.

About the hospital

Located in Xiamen, Fujian Province, The Affiliated Cardiovascular Hospital of Xiamen University (also known as Xiamen Cardiovascular Hospital or Xiamen Heart Center) is Fujian's only public tertiary grade A cardiovascular specialty hospital. Founded in 2001 as the Xiamen Heart Center, it affiliated with Xiamen University in 2016 and relocated to a new campus in Wuyuan Bay in 2019. The facility, recognized as one of China's most beautiful hospitals with international-standard design, has approximately 600 beds, 10 catheterization laboratories (including hybrid rooms) and six laminar flow operating rooms.

It is designated a National Regional Medical Center for Cardiovascular Diseases and a branch of the National Clinical Research Center for Cardiovascular Diseases. Cardiovascular medicine is a national key clinical specialty. The hospital performs a high volume of interventional procedures annually and specializes in complex coronary, valvular and arrhythmic interventions, including structural heart programs such as TEER and TAVR as one of China's early approved valve centers. In national public hospital performance evaluations it has received A-grade ratings, with its case-mix index (CMI) ranking second nationally for five consecutive years in the specialty surgery group. It operates an International Medical Center and has expanded with a north campus supporting international medical services, innovation and rehabilitation.