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EDWARDS LIFESCIENCES SAPIEN 3 TRANSCATHETER HEART VALVE; AORTIC VALVE, PROSTHESIS, PERCUTANEOUSLY DELIVERED
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| Model Number |
9600TFX23A |
| Medical Device Problem Code |
Degraded (1153)
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| Health Effect - Clinical Code |
Heart Failure/Congestive Heart Failure (4446)
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| Date of Event |
04/13/2026
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Type of Reportable Event
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Serious Injury
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Event or Problem Description
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It was initially reported by implant patient registry through receipt of an implant data card, that approximately 6 years, 4 months, 10 days post transfemoral tavr procedure with a 23mm sapien 3 valve, the patient's valve was explanted and replaced with a surgical valve.Per medical records provided, the valve was explanted due to structural valve degeneration associated with both aortic stenosis and aortic regurgitation.A transthoracic echocardiogram performed demonstrated thickened aortic valve leaflets with restricted motion and elevated gradients for the aortic prosthesis, including a mean gradient of 46.0 mmhg.The aortic valve area by continuity equation using the indexed diameter was 0.60 cm2, aortic valve area by velocity derived method was 0.59 cm2, aortic valve prosthetic effective orifice area was 0.61 cm2, and doppler velocity index was 0.30, all confirming severe stenosis.Additionally, central aortic regurgitation was observed and appeared severe.During the valve explantation procedure, extensive fungating calcification of the ascending aorta was identified, with the ascending aorta noted to be short and severely calcified along the lesser curvature, necessitating surgical replacement of both the ascending aorta and the hemi-arch.There was no documented evidence of calcification on the 23 millimeter sapien 3 valve leaflets.
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Additional Manufacturer Narrative
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Per the instructions for use (ifu), structural valve deterioration (wear, fracture, calcification, leaflet tear/tearing from the stent posts, leaflet retraction, suture line disruption of components of a prosthetic valve, thickening, stenosis), and device degeneration are known potential risks associated with the use of bioprosthetic heart valves.The ifu cautions that accelerated deterioration of the valve may occur in patients with an altered calcium metabolism.Long-term durability has not been established for the valve.Regular medical follow-up is advised to evaluate valve performance.Structural valve deterioration (svd) may be manifested as stenosis with thickened leaflets.Svd may be mild and not require any intervention or it may be moderate to severe.It can cause the heart to work harder to eject blood from the ventricle.Depending on the severity it could be an indication for valve replacement or medical intervention.Tissue calcification is a common failure mode.The mechanisms for bioprosthetic heart valve tissue calcification are not yet fully understood.Many factors can contribute to the onset and propagation of calcification including patient-related (e.G., patient age, disease state, immune status, and other co-morbidities), pharmacological, and intrinsic properties of the valve itself.It is widely understood that patients with chronic renal disease and prior history of calcific stenosis of the native valve may be predisposed to bioprosthetic calcification.During the manufacturing process, all sapien thv valves are 100% visually inspected for defects and 100% functionally tested for proper coaptation under physiological backpressure conditions prior to release for distribution.Therefore, it is highly unlikely that a manufacturing defect or device malfunction contributed to the event.In this case, there was no allegation or indication a manufacturing non-conformance contributed to this product problem.Although the exact cause and source of the degeneration cannot be determined, it is possible patient factors (hypertension and carotid artery disease) may have caused or contributed to the event.A review of edwards lifesciences risk management documentation was performed for this case.The reported event is an anticipated risk of the transcatheter heart valve procedure, additional assessment of this adverse event is not required at this time.Complaint histories for all reported events are reviewed against trending control limits monthly, and any excursions above the control limits are assessed and documented as part of this monthly review.As such, neither a product risk assessment, nor corrective or preventative actions are required at this time.
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