Maggie Nixon, Capstan Medical - Catheter-Based Surgical Robot | LSI USA '24

Maggie Nixon  0:02  
All right, so this is when the taco bar is kicking in lunch. It's awesome to be here. This has been my first time in LSI. And so it's been a great, it's been a great opportunity to just network with such a an amazing array of people. But it's, what I'm here for is to introduce Capstan Medical, which is a new look at how to address structural heart disease. This is just to anchor us. This is the data from 2019 from CDC. So heart disease continues to be the greatest cause of death in the US. And this data translates to worldwide. Heart disease is complex, though there are a ton of different things that go into that, that 23% All the way from ischemic diseases, to structural. So let's dig in here. But the structural heart market is dramatically under penetrated. And honestly, if you go into the keynote yesterday, with Bernard, I should have followed right after his talk, because he introduced the market opportunity even better there. But let's start with prevalence. So this age related structural heart is age related there are 56 million greater than 65 in the US. And the latest data that came out in 2023 is 13.5% of that population have some form of structural heart disease. So what is the prevalence look like by Valve. So prevalence by Valve, the vast majority of that is the mitral valve, just under 40%. And then you can see the aortic sits around a quarter of that tricuspid is fairly under diagnosed. However, it seems to be very concurrent with mitral, so the mixed percentage that you see there is very predominantly mitral and tricuspid. So let's look at what the treatment looks like. So on the right, you will see mitral and tricuspid, which is over 5 million patients. And it is about two and a half percent penetrated. Aortic, which is only 25% of that population. That's that's there is around 12% penetrated. And you start to look at that. And you're like, why is that? Well, that's because that's because this is the standard of care. For mitral open heart surgery is traumatic, it is painful, the recovery is really, really challenging. And so people avoid this, because they really, really don't want to to have this be their, their, their treatment method. So our team looked really hard at this. And it was very quickly seen that the current devices that are out there are amazing, the gen one devices that are really starting to collapse down small, they're they're getting into position. But they have 70 to 90% exclusion. So they're not compatible with the patients that are out there. And so when the team was digging in, I'm like, Well, why is that? It's because the valve needs to be really compact. So if the valve needs to be really compact and precise, you need a way to get it there and position it very precisely. And so precise valve technology can really leverage robotics. So let's see what that looks like. So we're going for precise, predictable and compact. What you see here is this is our device. This is running it on our simulated model. On the left, you see our digital twin, this is all the commands that are being put into our robot to drive the catheter, and then you're seeing the catheter here. So let's start with compact. This is femoral access transseptal, less than 32 French, which is what the clinical market believes can be compatible with the vast majority of patients. The end payload is 35 millimeters, which gives it a high level of maneuverability. But what you'll see here, it has a huge range of motion, incredibly tight curves, that can put it into position because it's leveraging robotic architecture. And the other thing you see here is as you unsheath the valve does not pop open. This is all cinched down internally. So you can do slow and controlled deployment of the implant all the way through the intervention. You can reposition, you can optimize the position you can double and triple check your imaging. As when you get open a little bit beyond this, the new leaflets start to activate we do not need to fast pace these patients in order to do this. And when you are perfectly happy with the positioning, you release the valve and you're done. This is the product that we will take the first inhuman this year. Though in the future, we are already mapping algorithms to back out and who's got a backup camera on their car. That's one of the biggest challenges in structural heart right now you do an amazing intervention, and then you got to get out of the leaflets. And so we're working through the backup camera. So how capstan is looking at this is we have a robotic platform and highly capable catheters that you just saw an action. Just where we saw the biggest need in this market is mitral valve. And so we are starting with the mitral valve. And this is the first inhuman product that we are targeting. At the end of this year. We have a tricuspid valve that's queued up behind this as well, this has already been integrated with the robot has gone through early preclinical testing, and is ready to take off the shelf and move into full testing once we were highly focused on Mitel right now. But the really interesting thing that we've learned over this past year, from our clinical advisors and the cardiologists that we're talking to, they said if they have this device in their clinic, they would do the aortic, and so, which I was kind of surprised about. But I spent the first 20 plus years of my career at a company known as Intuitive Surgical. And it was really interesting because I thought about it, and it was like the robot had had foundational surgeries like prostatectomy that couldn't be done minimally invasive without it. But now how is that being used, it's being used across a ton of different procedures. And, and kind of fondly known as pull throughs. If you have a good highly capable device in your clinic, you're going to use it. And so we have put into our roadmap, an aortic that will go further down. I want to call this out, though, this happens comes together with a very purposefully curated team. So we brought a team together in structural heart. And in robotics, we have representation for all the main heart valve companies, and all the main robotic companies. We very purposefully had placed them in Santa Cruz, which is near the talent pool of the Bay Area, but with a really entrepreneurial and creative vibe on the coast in California. But so this team has pulled together we are actually I'm actually not in an active race right now. We closed our series B last year and we will be moving forward with a Series C either later this year or early 2025. We're scoping it out right now. But we are taking the full platform program forward. But with that, that's what I have. Thank you