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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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It was reported that a patient with a 21mm 8300ab aortic valve underwent a valve-in-valve procedure after an implant duration of 7 years, 8 months due to pvl.The patient presented with symptomatic symptoms of congestive heart failure, and shortness of breath.The tavr was successfully performed with a 23mm 9755rsl valve.
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H10: additional manufacturer narrative: updated sections: d4 (expiration date), g3, g6, h2, h4, h6 (type of investigation, investigation findings, and investigation conclusions).Regurgitation is considered to be a pvl [paravalvular leak] if a turbulent eccentric jet originates between the bioprosthetic sewing ring and the annulus.Late paravalvular regurgitation most commonly occurs in the setting of infective endocarditis-related abscess formation which predisposes to suture dehiscence or the gradual resorption of partially debrided annular calcifications.Technique related factors, such as incorrect valve sizing, have been shown to contribute to the development of pvl.Under sizing can lead to a gap between the annulus and sewing ring since the valve implanted is too small in relation to the annulus.Anatomical factors may create difficulty seating the bioprosthetic valve resulting in pvl.The anatomy of the annulus may induce mechanical stresses along the rigid bioprosthetic ring which can influence long-term valve performance and durability.A diseased or rigid annulus can potentially increase the mechanical stress on the prosthetic valve, leading to pvl.The instructions for use (ifu) have been reviewed, and no inadequacies have been identified with regard to warnings, contraindications, and the directions/conditions for the successful use of the device.The reported type of event is included in the ifu.A dhr review was performed, and no related manufacturing nonconformances were identified.A definitive root cause cannot be conclusively determined; however, patient and/or procedural factors likely caused or contributed.
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