H10: additional manufacturer narrative: the subject device is not available for evaluation as it remains implanted in the patient.The investigation is still in progress; therefore, a conclusion has yet to be established.A supplemental report will be submitted accordingly upon investigation completion.Edwards will continue to review and monitor all reported events.Trends are monitored on a monthly basis and if action is required, appropriate investigation will be performed.
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Edwards received notification that this patient with a 8300ab23 valve implanted in aortic position underwent a valve in valve procedure after an implant duration of approximately 8 years and 7 months due to degeneration leading to stenosis (mean gradient 52mmhg) with hypomobility of the flaps.As reported, patient presented with chest pain and dyspnea.A 23mm transcatheter valve was successfully implanted within the pre-existing edwards surgical device.As reported, patient was noted as to be very good and discharged home.
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Updated section h6 (investigation findings) and h6 (investigations conclusions).The serial number was not provided.Therefore, the device history record (dhr) could not be reviewed.Tissue degeneration-related structural deterioration, either calcific or non-calcific, are common chronic failure modes for this type of bioprosthetic heart valve.Operational mechanical stress and biological factors are generally believed to be the major contributors to the non-calcific bioprosthetic tissue degeneration.Structural valve deterioration (svd) can, and typically does, lead to chronic central leaks over a period of time.Svd is the most common reason for bioprosthesis explant and encompasses multiple failure modes, including calcification, non-calcific degeneration, dehiscence, cusp thickening or fibrosis, or a combination of these.Such failure modes may occur singularly or concomitantly.Degeneration-related structural deterioration is most commonly related to patient factors and is not usually an indication of a device malfunction.A definitive root cause cannot be conclusively determined; however, patient factors likely caused or contributed including patient age at the time of the implant (approximately 49 years old).
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