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Edwards received notification of an evoque valve in tricuspid position where, the procedure was completed successfully, with trace central tricuspid regurgitation (tr) and no paravalvular leak (pvl).On post-operative day (pod) 2, the patient was noted to be in complete heart block and subsequently received a permanent pacemaker.
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The following sections were updated/corrected/added: b4, g3, g6, h2, h6 and h11.H6 type of investigation: additional code 'labelling review'.The complaint for valve interacts with conduction system was confirmed with other empirical evidence via information reported by edwards clinical specialist.No manufacturing non-conformities was found during dhr review.A definite root cause is unable to be determined.Since no edwards defect was identified, corrective or preventative actions are not required.Per the instructions for use (ifu), conduction system disturbance and/or heart block which may require treatment (including permanent pacemaker) are potential adverse events.Heart block and other conduction disturbances are common in patients with underlying cardiovascular disease and can be exacerbated or aggravated with standard intra-operative medications or anesthesia.Such events are related to the patient's underlying condition.Other mechanisms for conduction abnormalities could be related to coronary obstruction due to air embolism, coronary spasm and/or local edema affecting the av node.Conduction disturbances have also been documented during transcatheter cardiac procedures as a result of direct interaction with cardiac anatomy, especially in patients with underlying conduction abnormalities.Other potential causes include trauma by a guidewire or delivery system.
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