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H11: additional manufacturer narrative: updated: g3, g6, h2, h6: (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.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 hyperlipidemia, coronary artery disease, diabetes mellitus, former smoker.
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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.
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It was learned through implant patient registry and investigation that a patient with a 23mm 11500a aortic valve was explanted after an implant duration of 3 years, 6 months due to severe calcification, degeneration, and severe stenosis.The explanted valve was replaced with a 23mm 3300tfx valve.Per medical records, the patient presented with symptoms of heart failure and underwent redo-redo avr and mvr.A 23mm 3300tfx aortic valve was implanted with non-pledgeted mattress sutures.Mvr with a non-edwards 31mm duran band.The patient tolerated the procedure well and was discharged on pod #7.Hospital pathology report: gross exam only of aortic valve.All leaflets are severely calcified with very limited mobility.There are no cuspal tears, perforations or thrombus, and no pannus formation.
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