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H11: additional manufacturer narrative: the device history record (dhr) review was completed, and this device passed all manufacturing and sterilization inspections prior to release for distribution.There were no issues identified that would have impacted this event.Engineering evaluation summary: per (b)(4), 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.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.A device history record (dhr) review was performed, and no relevant non-conformances were identified.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 history of dyslipidemia and smoking.
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It was reported and learned through medical record that a 29mm 7300tfx mitral valve in mitral position was disabled via valve in valve procedure after an implant duration of 2 years, 10 months due to degeneration with mixed valve disease and fused leaflet.The patient presented with heart failure, following extensive hospitalization for heart failure symptom management.Tmvr was completed with a 29mm 9755rsl transcatheter valve.Per medical records, tee demonstrated moderate eccentric mitral regurgitation with severely restricted mobility of leaflets and stenosis.Cardiology noted degenerative ms findings and recommended tmvr.Patient underwent successful tmvr with improvement in symptoms.
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