|
Edwards received notification of a transcatheter tricuspid valve replacement (ttvr) procedure involving the evoque system.Following valve release at the annulus, complete heart block was observed immediately.No procedural maneuvers were identified as contributing to the rhythm change.Due to the sustained complete heart block, a permanent pacemaker was implanted.The patient was reported to be in stable condition.
|
|
The following sections were updated/corrected/added: b4, g3, g6, h2, h6, and h11.The complaint for valve interacts with conduction system was confirmed with other empirical evidence.The device history record review was completed, and this device passed all manufacturing and sterilization inspections.Per the instructions for use (ifu), conduction system disturbance and/or heart block which may require treatment (including permanent pacemaker) are potential adverse events.Heart block and other conduction disturbances are common in patients with underlying cardiovascular disease and can be exacerbated or aggravated with standard intra-operative medications or anesthesia.Such events are related to the patient's underlying condition.Other mechanisms for conduction abnormalities could be related to coronary obstruction due to air embolism, coronary spasm and/or local edema affecting the av node.Conduction disturbances have also been documented during transcatheter cardiac procedures as a result of direct interaction with cardiac anatomy, especially in patients with underlying conduction abnormalities.Other potential causes include trauma by a guidewire or delivery system.Additionally, cardiac conduction system complications are known risks with tricuspid valve interventions due to the proximity of the atrioventricular node (av node) to the septal leaflet of the tricuspid valve.These conduction disturbances can lead to post-operative heart block requiring pacemaker implantation.Nevertheless, a definitive root cause cannot be determined.Since there are no confirmed product or labeling/ifu/training material non-conformances affecting distributed product and no other triggers have been met, no corrective or preventative actions are required.
|