K Number
K121083
Device Name
TRUE DILATATION PERCUTANEOUS TRANSLUMINAL VALVULOPLASTY CATHETER, 20MM X 4.5CM, TRUE DILATATION PERCUTANEOUS TRANSLUMINA
Manufacturer
Date Cleared
2012-10-11

(184 days)

Product Code
Regulation Number
870.1255
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The TRUE Dilatation™ Catheter is indicated for balloon aortic valvuloplasty.
Device Description
The Loma Vista Medical (LVM) TRUE Dilatation™ Catheter is a coaxial catheter with a balloon fixed at the tip used for Balloon Aortic Valvuloplasty (BAV) of the aortic valve. The effective length of the catheter is 110 cm and it has two lumens: one lumen is used to inflate and deflate the balloon and the other permits the use of a guidewire to position the catheter. The balloon inflation luer-lock hub (angled) connects to a syringe inflation device to deliver radiopaque contrast media for inflation. The guidewire luer-lock hub (straight) connects to the guidewire lumen.
More Information

NuCLEUS, K082776

Not Found

No
The summary describes a mechanical balloon catheter and does not mention any software, algorithms, or data processing that would indicate the use of AI/ML.

Yes
The device is indicated for "balloon aortic valvuloplasty," which is a medical procedure performed to treat a medical condition (aortic valve stenosis), directly aligning with the definition of a therapeutic device.

No

The device is a therapeutic balloon catheter used for balloon aortic valvuloplasty, a treatment procedure, not for diagnosis.

No

The device description clearly describes a physical catheter with a balloon, lumens, and hubs, indicating it is a hardware device, not software-only.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD Definition: In Vitro Diagnostic devices are used to examine specimens taken from the human body (like blood, urine, tissue) to provide information about a person's health. This testing is done outside of the body.
  • Device Function: The TRUE Dilatation™ Catheter is a medical device used inside the body during a surgical procedure (Balloon Aortic Valvuloplasty). It is used to physically dilate the aortic valve.
  • Intended Use: The intended use clearly states "balloon aortic valvuloplasty," which is a therapeutic procedure performed on a patient.

The device description and intended use clearly indicate that this is an invasive medical device used for treatment, not for diagnostic testing of samples outside the body.

N/A

Intended Use / Indications for Use

The TRUE Dilatation™ Catheter is indicated for balloon aortic valvuloplasty.

Product codes (comma separated list FDA assigned to the subject device)

OZT

Device Description

The Loma Vista Medical (LVM) TRUE Dilatation™ Catheter is a coaxial catheter with a balloon fixed at the tip used for Balloon Aortic Valvuloplasty (BAV) of the aortic valve. The effective length of the catheter is 110 cm and it has two lumens: one lumen is used to inflate and deflate the balloon and the other permits the use of a guidewire to position the catheter. The balloon inflation luer-lock hub (angled) connects to a syringe inflation device to deliver radiopaque contrast media for inflation. The guidewire luer-lock hub (straight) connects to the guidewire lumen.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

aortic valve

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Functional and Safety Testing: To verify that the device design met its functional and performance requirements, representative samples of the device underwent biocompatibility, sterility, packaging integrity, and mechanical testing in accordance with ISO 10993-1 2009, ISO 11135-1 2007, ASTM D4169:2009, ISO 10555-1 2009. Additional performance bench testing was performed and is summarized below.

In Vivo Performance Testing: Two separate European clinical studies were performed to confirm bench test data, to ensure design features continue to meet clinical needs, and to provide in vivo data to demonstrate safe and effective use of the TRUE Dilatation Catheter as to the predicate device. Data collected included device performance, procedural data, and clinical outcomes. Data was collected for 69 devices used in 69 clinical procedures. The data provides objective evidence that the TRUE Dilatation Catheter can be used safely and effectively in BAV procedures compared to the predicate device. In addition, the clinical experience confirms that the TRUE Dilatation Catheter can be successfully used for pre-dilatation prior to transcatheter aortic valve implantation, in comparison to the predicate. The success of the TAVI procedure confirms that the TRUE Dilatation Catheter as effective as the predicate in BAV procedures and allows for successful placement of TAVI devices. The absence of any adverse events (0/69) indicates that the device is safe as compared to the predicate. In addition, there have been no reports of any adverse events since the European commercial launch representing more than 400 TRUE procedures to date. The absence of device failures and device related adverse events demonstrates the equivalency of the TRUE Dilatation Catheter to the predicate NuCLEUS device.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Key Metrics are presented in table format for "Functional and Safety Testing" and include a pass rate for each test.

  • Visual Inspection: 61 of 61 catheters passed.
  • Balloon Preparation Test: 61 of 61 catheters passed.
  • Diameter and Profile Test: 61 of 61 catheters passed.
  • Balloon Distensibility: 61 of 61 catheters passed.
  • Repeated Balloon Inflation: 61 of 61 catheters passed.
  • Balloon Minimum Burst Strength: A total of 98 samples across all device sizes tested and passed 95% confidence with 99.9% reliability.
  • Balloon Inflation / Deflation Test: 60 of 60 catheters met acceptance criteria.
  • Balloon Deflatability Test: As evidenced by observed deflation, 60 of 60 samples passed.
  • Tip Pull and Torque Test: 20 of 20 catheters passed. No reported breaks.
  • Bond Strength Test: 29 of 29 samples passed.
  • Catheter Body Maximum Pressure Test: 20 of 20 catheters withstood 30 ATM.

Key Metrics for "In Vivo Performance Testing":

  • Absence of any adverse events (0/69)

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

NuCLEUS, 510(k) number K082776

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 870.1255 Balloon aortic valvuloplasty catheter.

(a)
Identification. A balloon aortic valvuloplasty catheter is a catheter with a balloon at the distal end of the shaft, which is intended to treat stenosis in the aortic valve when the balloon is expanded.(b)
Classification. Class II (special controls). The special controls for this device are:(1) The device must be demonstrated to be biocompatible.
(2) Sterility and shelf life testing must demonstrate the sterility of patient-contacting components and the shelf life of these components.
(3) Non-clinical performance evaluation must demonstrate that the device performs as intended under anticipated conditions of use, including device delivery, inflation, deflation, and removal.
(4) In vivo evaluation of the device must demonstrate device performance, including the ability of the device to treat aortic stenosis.
(5) Labeling must include a detailed summary of the device-related and procedure-related complications pertinent to the use of the device.

0

K121083

OCT 1 1 202

Revised 510(k) Summary
Submitter:Loma Vista Medical
863A Mitten Road, Suite 100A
Burlingame, CA 94010
Phone: (650) 490-4747
Fax: (650) 240-0761
Email: paul@lomavistamedical.com
Contact Person:Tiffini Diage
1307 South Mary Avenue, Suite 280
Sunnyvale, CA 94087
Phone: (707) 799-6732
Fax: (408) 462-9132
Email: tdiage@namsa.com
Date Prepared:8/27/2012
Trade Name:TRUE Dilatation™ Balloon Valvuloplasty Catheter
Classification:Class II
Balloon Aortic Valvuloplasty
21 CFR 870.1255
Product Code:OZT
Predicate Device(s):The subject device is equivalent to the following devices:
NuCLEUS, 510(k) number K082776
Device Description:The Loma Vista Medical (LVM) TRUE Dilatation™ Catheter is
a coaxial catheter with a balloon fixed at the tip used for
Balloon Aortic Valvuloplasty (BAV) of the aortic valve. The
effective length of the catheter is 110 cm and it has two lumens:
one lumen is used to inflate and deflate the balloon and the
other permits the use of a guidewire to position the catheter. The
balloon inflation luer-lock hub (angled) connects to a syringe
inflation device to deliver radiopaque contrast media for
inflation. The guidewire luer-lock hub (straight) connects to the
guidewire lumen.
Indication for Use:The TRUE Dilatation™ Catheter is indicated for balloon aortic
valvuloplasty.
Functional and
Safety Testing:To verify that the device design met its functional and
performance requirements, representative samples of the device
underwent biocompatibility, sterility, packaging integrity, and
mechanical testing in accordance with ISO 10993-1 2009, ISO
11135-1 2007, ASTM D4169:2009, ISO 10555-1 2009.
Additional performance bench testing was performed and is
summarized below.
In Vivo Performance
TestingTwo separate European clinical studies were performed to
confirm bench test data, to ensure design features continue to
meet clinical needs, and to provide in vivo data to demonstrate
safe and effective use of the TRUE Dilatation Catheter as to the
predicate device. Data collected included device performance,
procedural data, and clinical outcomes. Data was collected for
69 devices used in 69 clinical procedures.
The data provides objective evidence that the TRUE Dilatation
Catheter can be used safely and effectively in BAV procedures
compared to the predicate device. In addition, the clinical
experience confirms that the TRUE Dilatation Catheter can be
successfully used for pre-dilatation prior to transcatheter aortic
valve implantation, in comparison to the predicate. The success
of the TAVI procedure confirms that the TRUE Dilatation
Catheter as effective as the predicate in BAV procedures and
allows for successful placement of TAVI devices. The absence
of any adverse events (0/69) indicates that the device is safe as
compared to the predicate. In addition, there have been no
reports of any adverse events since the European commercial
launch representing more than 400 TRUE procedures to date.
The absence of device failures and device related adverse events
demonstrates the equivalency of the TRUE Dilatation Catheter
to the predicate NuCLEUS device.
Conclusion:Loma Vista Medical considers the TRUE Dilatation Catheter to
be substantially equivalent to the predicate device listed above.
This conclusion is based upon the devices' similarities in
principles of operation, performance requirements, and
indications for use.

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Test PerformedTRUE Dilatation Acceptance CriteriaTRUE Dilatation Results
Visual InspectionWhen examined with 2.5X magnification, the external surface of the effective length of the catheter shall appear free from extraneous material, and process and surface defects.61 of 61 catheters passed.
Balloon
Preparation TestEach catheter shall be prepped per the procedure without functional difficulties or anomalies.61 of 61 catheters passed.
Diameter and
Profile TestBalloon diameter shall not deviate from stated balloon diameter by more than 1mm when inflated to 6 atm.61 of 61 catheters passed.
Balloon
DistensibilityInflated balloon diameter shall not increase more than 2% between nominal inflation pressure (3 atm) and maximum inflation pressure (6 atm).61 of 61 catheters passed.
Repeated Balloon
InflationThe balloon catheter shall not herniate or rupture after 10 inflation/deflation cycles to the maximum inflation pressure of 6 atm.61 of 61 catheters passed.

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:

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Test PerformedTRUE Dilatation Acceptance CriteriaTRUE Dilatation Results
Balloon Minimum
Burst StrengthThe results must show statistically that with
at least 95% confidence,
99.9% of the balloons will not burst at or
below the maximum recommended rated
burst pressure. All sizes must withstand a
minimum of 6 atm.A total of 98 samples across all
device sizes tested and passed 95%
confidence with 99.9% reliability.
Balloon Inflation /
Deflation TestThe balloon shall inflate in no more than 5
seconds and deflate in no more than 10
seconds.60 of 60 catheters met acceptance
criteria.
Balloon
Deflatability TestThere should be no interference with balloon
deflation.As evidenced by observed deflation,
60 of 60 samples passed.
Tip Pull and
Torque TestMust withstand at least 10 turns without
breaking.20 of 20 catheters passed. No
reported breaks. There is only 1
shaft size.
Bond Strength TestAll bonds must withstand at least 15N (3.4
lbs) pull strength.29 of 29 samples passed.
Catheter Body
Maximum Pressure
TestAll samples must withstand 30
ATM (400 psi).20 of 20 catheters withstood 30
ATM.

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/3/Picture/1 description: The image shows the seal of the U.S. Department of Health and Human Services. The seal features a stylized caduceus, a symbol often associated with medicine and healthcare, with three intertwined serpents. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" is arranged in a circular pattern around the caduceus. The seal is black and white.

Public Health Service

Food and Drug Administration 10903 New Hampshire Avenue Document Control Room-WO66-G609 Silver Spring, MD 20993-0002

OCT 11 2012

Loma Vista Medical c/o Ms. Tiffini Diage Regulatory Project Manager, NAMSA 1307 South Mary Avenue, Suite 280 Sunnyvale, CA 94807

Re: K121083

Trade Name: TRUE Dilatation™ Balloon Valvuloplasty Catheter Regulation Number: 21 CFR 870.1255 Regulation Name: Balloon Aortic Valvuloplasty Catheter Regulatory Class: Class II (two) Product Code: OZT Dated: August 24, 2012 Received: August 28, 2012

Dear Ms. Diage:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

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Page 2 - Ms. Tiffini Diage

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (OS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to

http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm.

Sincerely yours

Bram D. Zuckerman, M.D. Director Division of Cardiovascular Devices Office of Device Evaluation Center for Devices and Radiological Health

5

Indications for Use

510(k) Number (if known): K121083

Device Name: TRUE Dilatation Balloon Valvuloplasty Catheter

Indications For Use:

The TRUE Dilatation Balloon Valvuloplasty Catheter is indicated for balloon aortic valvuloplasty.

Over-The-Counter Use Prescription Use X AND/OR (Part 21 CFR 801 Subpart D) (21 CFR 801 Subpart C) (PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

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(Division Rign-Off) Division of Cordiovascular Devices 510(k) Mumber .. K12) 083