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H11: additional manufacturer narrative: the subject device is not available for evaluation, as it remains implanted in the patient.The investigation is still in progress; therefore, a conclusion has yet to be established.A supplemental report will be submitted accordingly upon investigation completion.
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It was reported that a 23mm 2700tfx aortic valve in aortic position was disabled via valve in valve procedure after an implant duration of 8 years, 7 months due to stenosis.The patient presented in heart failure requiring hospitalization and treatment.Tavr was completed with a 23mm 9755rsl transcatheter valve and patient was transferred to icu in stable condition.Per medical records, patient was admitted for valve-related heart failure requiring icu admission and further management.Patient refused savr and underwent tavr procedure with low cardiac output requiring short episode of chest compressions and discharged on pod3.Patient underwent tf-viv tavr with # 23 s3 post-dilated with 22 mm true balloon.
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H11: additional manufacturer narrative: updated sections: b4, g3, g6, h2, h6 (type of investigation, investigation findings, and investigation conclusions).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), stenosis is a common manifestation of bioprosthetic valve and valved conduit dysfunction and has many potential root causes, including structural valve deterioration (svd), non-structural valve dysfunction (nsvd), endocarditis and/or thrombosis.Bioprosthetic device stenosis is typically related to patient and/or procedural factors and is not typically an indication of a device malfunction related to a manufacturing deficiency.There is no evidence to suggest a manufacturing defect caused or contributed to the reported event.The most likely root cause is patient factors, including coronary artery disease, chronic kidney disease, hyperlipidemia and diabetes mellitus.
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