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Additional h6 (type of investigation) code: labelling review.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 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 device history record (dhr) review was performed, and no related manufacturing nonconformances were identified.Structural valve deterioration (svd) is a logical and expected consequence of the chemical, mechanical, and immunological processes associated with bioprosthetic heart valves (bhv) 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.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 chronic kidney disease, end-stage renal failure and coronary artery disease.Edwards will continue to review and monitor all events.Trends are monitored on a monthly basis and if action is required, appropriate investigation will be performed.
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Per the report received from australia, a 64-year-old patient with a valve model 7300tfx31 implanted in mitral position underwent a valve-in-valve intervention after an implant duration of one (1) year and five (5) months due to calcific degeneration leading to severe stenosis and severe regurgitation.Prior to the intervention, the patient presented with heart failure and was critically ill, intubated in the intensive care unit, and given a prognosis of 48 hours to live.The patient experienced multiple episodes of ventricular tachycardia (vt) arrest, 8 to 10, requiring defibrillation and one episode necessitating cardiopulmonary resuscitation (cpr) to restore cardiac output.A 29mm transcatheter valve was urgently deployed within the edwards surgical valve during a vt arrest.The procedure ended successfully, and the patient was reported to be stable and slowly recovering, with no neurological effects noted.
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