Per the instructions for use (ifu), valve thrombosis is a potential risk associated with the use of the transcatheter heart valves (thv).Thrombosis is a rare and well-recognized complication associated with the use of bioprosthetic heart valves.Valve thrombosis is the formation of significant blood clots forming on the valve.These clots could significantly impact the functionality of the valve resulting in heart failure or thromboembolism.Anticoagulation therapy must be evaluated patient by patient.The cause for valve thrombosis is thought to result from an interaction between components of blood and the prosthesis or turbulent blood flow in and around the prosthesis.Several factors can cause development of thrombosis, including: inadequate anticoagulant therapy after valve implant, atrial fibrillation, medications, cancerous tumors, systemic diseases (e.G., systemic lupus erythematosus, inflammation and damage to various body tissues, including joints, skin, kidneys, heart, lungs, blood vessels, and brain), and reduced cardiac pumping (low ejection fraction).Thrombosis has an extremely low incidence rate in bioprosthetic heart valves.Thrombosis is a complex process triggered by the interaction between the host and the device and is highly variable among patients.Since the mechanism of thrombotic deposition on bioprosthetic heart valves is not fully understood, the cause cannot always be confirmed.In this case, there was no allegation or indication a device malfunction contributed to this adverse event.With the limited information provided, the cause of the thrombosis is unknown but the mechanisms above could be contributing factors.A complaint history for this type of event is reviewed against trending control limits on a monthly basis, and any excursions above the control limits are assessed and documented as part of this monthly review.No corrective or preventive actions are required.
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As reported by the edwards (b)(6) affiliate through the (b)(6) registry reporting system, the sapien 3 valve was deployed in a native aortic position via transfemoral approach uneventfully.On postoperative day (pod) 11, hypo-attenuated leaflet thickening (halt) was suspected.It was unknown if the patient required any treatment, however, the outcome was reported as in remission on pod-18.Per medical opinion, this serious injury, which required prolonged hospitalization, was associated with edwards¿ device, not tavr procedure.No patient information is available.The device remains deployed in patient and will not be returned for evaluation.
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