Management of TAVI Candidates With Metal Allergy: Minimally Invasive Aortic Valve Replacement With a Metal-Free Bioprosthesis
Year: 2025
Type: article
Study design: Case Report
Abstract: An 87-year-old woman with severe aortic stenosis required intervention. Patch testing demonstrated nickel and cobalt hypersensitivity, ruling out transcatheter valve implantation. After multidisciplinary review, minimally invasive aortic valve replacement through a right anterior thoracotomy was chosen, thereby avoiding median sternotomy and stainless steel wires. A 21-mm Avalus bioprosthesis (Medtronic)-engineered without a metallic stent-was implanted successfully. Recovery was smooth. Extubation occurred within hours, and the patient was discharged from the hospital on postoperative day 5. At 1 year, prosthetic performance and clinical status were excellent. This experience illustrates a practical path when transcatheter treatment is contraindicated by documented metal allergy: minimally invasive surgery with a metal-free valve.
Authors: Naoto Tanabe, Hiroshi Tsuneyoshi, Tomofumi Taki, Shoichi Kyo, Akira Takeuchi, Koki Tamaoka, Ryo Nakanishi, Hiroto Kawakami
Institution: Shizuoka General Hospital
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $975
OpenAlex ID: W4416420722