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Clinical information: (b)(4) - sh device registry, patient site id: (b)(6).It was reported that on (b)(6) 2025, a 31mm masters series mechanical heart valve was successfully implanted in a patient.A postoperative echocardiogram in the intensive care unit (icu) showed severe grade 3-4 mitral regurgitation, leading to reoperation within 24 hours.During reoperation, an attempt to rotate a 31mm non-abbott replacement valve, a rupture occurred.The patient required extracorporeal membrane oxygenation (ecmo) implantation, followed by another operation due to bleeding.Ultrasound again showed abnormalities in the 31mm non-abbott replacement valve, specifically a fixed posterior disc, leading to another reoperation and replacement with a 29mm epic plus mitral valve.On (b)(6) 2025, it's noted that the patient began suffering from cardiac tamponade.Cardiac tamponade was confirmed by transesophageal ultrasound after the patient, who had been progressing favorably, experienced sudden hemodynamic deterioration.Daily ultrasound studies performed at the bedside in the icu did not reveal any pericardial effusion prior to confirming cardiac tamponade.A surgical revision/intervention was performed, but no active bleeding site was noted.The patient remained under ecmo therapy.On (b)(6) 2025, the patient present with acute mitral regurgitation due to a st-elevation myocardial infarction.A coronarography revealed a severe lesion in the mid-circumflex artery with no other significant anomalies.It was noted that the patient presented with typical angina.A catheterization was performed and revealed significant stenosis of the left main coronary artery to a thrombus of unknown origin.Mitral regurgitation was diagnosed by echocardiography.The decision was made to perform a percutaneous intervention of the mid-circumflex artery and left main coronary artery.The cardiac tamponade was caused by anticoagulation and platelet dysfunction due to ecmo, along with factor xiii deficiency.The mitral regurgitation was of ischemic origin, caused by rupture of the papillary muscle.The thrombus at the origin of the left main coronary artery was believed to be caused by va-ecmo (venoarterial extracorporeal membrane oxygenation), which can lead to aortic root thrombus formation due to insufficient forward flow across the aortic valve, resulting in blood stasis and clot formation.The implanting physician attributed the st-elevation myocardial infarction (stemi) to the patient¿s multiple cardiovascular risk factors, including hypertension, dyslipidemia, obesity, and active smoking.The patient¿s typical angina symptoms were attributed to coronary lesions.The patient was discharged after a 3-month hospital stay and is in good clinical condition, although motor function is still recovering due to the prolonged hospitalization.
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An event involving central regurgitation and valve fracture was reported.A more comprehensive assessment, including histopathological examination of the valve tissue could not be performed as the device remains implanted and was not returned for analysis.The device history record was reviewed and confirmed that all manufacturing and inspection processes were completed and the product met specifications.However, the exact cause of the reported event could not be conclusively determined.The patient outcomes appear to be a cascade of events following the initial regurgitation, but this cannot be conclusively detremined.The reported surgical intervention was result of case specific circumstances.There is no indication of a product quality issue with respect to labeling design or manufacturing of the device.
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