|
H11: additional manufacturer narrative: 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.
|
|
It was reported that a patient with a 25mm 2700tfx aortic valve underwent emergency valve-in-valve procedure after an implant duration of 9 years, 5 months due to severe calcification and degeneration.The patient presented with acute heart failure.Tavr was successfully performed with a 26mm 9755rsl valve.The patient was taken to recovery in stable condition post-procedure and discharged on pod #3.Per medical records, patient presented in the er with chest pain/nstemi underwent lhc.Tee showed severe calcification and degeneration of the bioprosthetic aortic valve with severe stenosis, mg 50mmhg and severe transvalvular regurgitation.The patient became hemodynamically unstable and underwent emergent viv.
|
|
H11: additional manufacturer narrative: updated: g3, g6, h2, h6: (component code, investigation findings, investigation conclusions).The device history record (dhr) was not reviewed as the reported event does not allege a malfunction that could be related to an edwards manufacturing deficiency and/or one was not confirmed through investigation.Svd is a logical and expected consequence of the chemical, mechanical, and immunological processes associated with 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.Despite the advancements in the heart valve industry, svd commonly begins 7 to 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 hyperlipidemia (hld), and coronary artery disease (cad).
|