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Accurate device navigation and control are significant challenges in various minimally invasive cardiovascular interventions. The long length of the devices used (e.g., catheters and guidewires), their high flexibility, and their engagement with the tortuous anatomy limit the accurate and reliable control and navigation of the device's tip. This article aims to design, develop, and assess a novel alternative solution that promises to overcome the major limitations of conventional devices. By utilizing an expandable cable-driven mechanism and a corresponding 3-D cam surface for cable length adjustment, we propose a fully manually operated system that can be navigated through the tortuous anatomy and then teleoperated to allow for accurate, reliable, and localized position control and tracking of the device. In this article, the methods of design, development, and verifications of this system are presented. The system's performance is assessed under different path tortuosity conditions and different opening diameters of the expandable frame. Our results indicate that the proposed system provides complete teleoperation of the device within the full reachable workspace of the mechanism and allows for positioning and tracking of the device with submillimeter accuracy irrespective of the tortuosity of the path and expansion size of the frame. Ex-vivo phantom model experiments also show the device significantly outperforms conventional devices in terms of navigation time and success rate. The CathPilot allows for direct manipulation, accurate positioning, and tracking of the device tip relative to the anatomy, promising to overcome Manuscript

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