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It was reported that a patient with a 3000 19 mm aortic valve is being evaluated for a valve-in-valve procedure after an implant duration of 9 years, 11 months due to calcification, stenosis, and regurgitation.The patient presented with heart failure.The patient expired (b)(6) 2026 due to biventricular failure and likely cardiogenic shock c/b mof and lactic acidosis.
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H11.Additional narrative: updated h6.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- 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, hld, ckd, cad, smoking, and atherosclerosis.
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