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H11: additional manufacturer narrative: this report serves as both the initial and final medical device report (mdr), incorporating the findings from the investigation.The device was not returned to edwards for evaluation as it remains implanted.The instructions for use (ifu) have been reviewed, and no inadequacies have been identified with regards to warnings, contraindications, and the directions/conditions for the successful use of the device.The reported type of event is included in the ifu.The device history record review was completed, and this device passed all manufacturing and sterilization inspections.No nonconformances related to the complaint event were identified.Svd (structural valve degeneration) is a logical and expected consequence of the chemical, mechanical, and immunological processes associated with bhv (bioprosthetic heart valves) implantation.The common endpoint of all these factors is calcification and degradation.Svd is an acquired condition, intrinsic to bioprosthetic valves, characterized by deterioration of the leaflets or supporting structures, leading to thickening, calcification, tearing, or disruption of the prosthetic valve materials.These changes result in valvular dysfunction manifesting as stenosis and/or regurgitation with a consequent drop in hemodynamic efficacy of the valve.Despite the advancements in the heart valve industry, svd commonly begins 7- 8 years after implantation, with a considerably increased rate in patients with pertinent comorbidities and/or an implant duration of greater than 10 years.Prior investigations and extensive literature review have shown that svd is predominantly related to patient factors and implant duration rather than to manufacturing issues.Events related to device design, manufacturing, or use error tend to manifest at an earlier implant duration.There is no evidence to suggest a manufacturing defect caused or contributed to the reported event.Based on the information available, the most likely root cause is patient factors, including an implant duration of 7 or more years.Since no edwards defect was identified, corrective or preventative actions are not required.
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Edwards received notification from taiwan, that this 67-year-old patient with a valve model 7300tfx27 implanted in the mitral position underwent a valve-in-valve intervention after an implant duration of at least seven (7) years and eight (8) months due to calcification, which led into mitral stenosis.The patient presented with fatigue before the procedure.A transcatheter valve was implanted in replacement, and the patient was noted as to be safe and stable.The implant date is only known as "2017".Therefore, (b)(6) 2017 is being used to calculate the minimum implant duration.
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