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Stenosis and/or regurgitation, which develops progressively over time, can be due to a number of issues.Additionally, there can be a number of potential known and unknown patient related contributing factors.Structural valve deterioration (svd) is the most common reason for bioprosthesis explants 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, may contribute to stenosis and/or regurgitation.The root cause of this event cannot be conclusively determined with the available information.However, the stenosis and regurgitation in this case were most likely impacted by the progression of the patient's underlying valvular disease pathology with structural valve deterioration.Of note, this pericardial aortic valve was initially used off label as it was implanted in the pulmonic position.Per the instructions for use (ifu), 'the carpentier-edwards perimount pericardial bioprosthesis is intended for use in patients whose aortic valvular disease is sufficiently advanced to warrant replacement of their natural valve with a prosthetic one.' the subject device is not available for evaluation, as it remains implanted in the patient.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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It was reported that a patient with a 29mm 2700 aortic valve, implanted in the pulmonic position, underwent a valve-in-valve procedure after an implant duration of nine (9) years, two (2) months due to severe degeneration leading to severe pulmonary stenosis, severe pulmonary regurgitation, and perivalvular leak (pvl).The tpvr was performed with a 29mm 9600tfx transcatheter valve successfully.The patient was transferred to recovery area in hemodynamically stable condition.
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H10: additional manufacturer narrative: updated sections d4 (expiration date), h4, h6 (type of investigation) the device history record (dhr) review was completed and this device passed all manufacturing and sterilization inspections prior to release for distribution.There were no issues identified that would have impacted this event.H11: corrected data: corrected section h6 (device code).
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