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It was reported that on (b)(6) 2026, a 29 mm navitor vision valve was selected for implant using a large flexnav delivery system.The patient had a history of right bundle branch block (rbbb), which was also the patient's baseline rhythm prior to the procedure.The membranous septum length was 2.5 mm.It was reported that there was no calcification extending beneath the aortic annular plane into the interventricular septum.During the procedure, while in the cusp overlap view (cov), the inflow edge of the constrained valve within the capsule was positioned at the base of the aortic annulus and the pigtail position was confirmed at the bottom of the non-coronary cusp (ncc).The initial implant depth was 3 mm; however, the valve was recaptured to achieve optimal depth on the left side.The final implant depth at release was 5 mm.A temporary pacemaker was used during the procedure, and the patient left the catheterization laboratory with the temporary pacemaker in place.Following the procedure, the patient's rhythm was reported to be similar, and the physician elected to observe the patient.The patient left the procedure room with rbbb, which was the same rhythm present prior to the procedure.The patient remained hemodynamically stable throughout the procedure.No clinically significant delay was reported.The patient was monitored with the temporary pacemaker in place.After observation, on (b)(6) 2026, the physician determined that a pacemaker was needed, and the patient received a permanent pacemaker.It was reported that the patient's pre-existing rbbb worsened 24 to 48 hours after the procedure, which led to the decision to implant a permanent pacemaker.The patient had a prolonged hospital stay for rhythm monitoring and remained an additional night in the hospital.The implanter classified the event as related to the procedure and the patient's past medical history.The patient's status was reported as stable and discharged.
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