Aortic valve replacement in a patient with self-reported systemic multiple metal allergy

Area of Science:

• Cardiovascular Surgery
• Allergy and Immunology
• Biomaterials Science

Background:

• Severe aortic stenosis necessitates valve replacement.
• Systemic metal allergy presents a significant challenge for implantable device selection.
• Traditional bioprosthetic valves may contain metal components, posing risks for allergic patients.

Observation:

• A 74-year-old male patient presented with severe aortic stenosis.
• The patient had a history of palmoplantar pustulosis and diagnosed systemic metal allergy.
• Standard treatment options were limited due to metal hypersensitivity.

Findings:

• Aortic valve replacement was performed using the Avalus bioprosthetic valve.
• The Avalus valve features a metal-free stent design.
• The patient tolerated the procedure and implant well, with no signs of allergic reaction.

Implications:

• The Avalus bioprosthetic valve offers a safe and effective alternative for aortic valve replacement in patients with metal allergies.
• This case highlights the importance of considering patient-specific allergies in device selection for cardiac surgery.
• Further research into metal-free cardiovascular implants is warranted to expand treatment options.