[Mitral and Aortic Valve Replacement and Tricuspid Valve Repair in a Patient with Metal Allergy]. 2021

Toshimichi Nonaka, and Kazuki Kato, and Mayumi Kamada, and Masayoshi Tokoro, and Motoshi Kosakai, and Takahisa Sakurai, and Hajime Sakurai
Department of Cardiovascular Surgery, Chukyo Hospital, Nagoya, Japan.

We report a 63-year-old woman came to our hospital with exertional dyspnea, palpitations, and abdominal distention. Echocardiography showed mitral, aortic, and tricuspid valve insufficiency, for which surgery was indicated. Twenty-six years ago, during dental therapy, she was diagnosed with metal allergy. A patch test demonstrated allergic reactions to manganese, chromium, and zinc. The patient underwent mitral and aortic valve replacement with the On-X prosthetic heart valve, which is primarily made of titanium and devoid of the allergens. She also underwent tricuspid valve repair with a Contour 3D annuloplasty ring, which is made of titanium alloy. She manifested no allergic symptoms three years after surgery. This case elucidates the importance of history taking regarding metal allergy and identification of allergens by patch testing in patients undergoing cardiac surgery involving metal device implantation.

UI MeSH Term Description Entries
D006967 Hypersensitivity Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. Allergy,Allergic Reaction,Allergic Reactions,Allergies,Hypersensitivities,Reaction, Allergic,Reactions, Allergic
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D008944 Mitral Valve Insufficiency Backflow of blood from the LEFT VENTRICLE into the LEFT ATRIUM due to imperfect closure of the MITRAL VALVE. This can lead to mitral valve regurgitation. Mitral Incompetence,Mitral Regurgitation,Mitral Valve Incompetence,Mitral Insufficiency,Mitral Valve Regurgitation,Incompetence, Mitral,Incompetence, Mitral Valve,Insufficiency, Mitral,Insufficiency, Mitral Valve,Regurgitation, Mitral,Regurgitation, Mitral Valve,Valve Incompetence, Mitral,Valve Insufficiency, Mitral,Valve Regurgitation, Mitral
D005260 Female Females
D006350 Heart Valve Prosthesis A device that substitutes for a heart valve. It may be composed of biological material (BIOPROSTHESIS) and/or synthetic material. Prosthesis, Heart Valve,Cardiac Valve Prosthesis,Cardiac Valve Prostheses,Heart Valve Prostheses,Prostheses, Cardiac Valve,Prostheses, Heart Valve,Prosthesis, Cardiac Valve,Valve Prostheses, Cardiac,Valve Prostheses, Heart,Valve Prosthesis, Cardiac,Valve Prosthesis, Heart
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001021 Aortic Valve The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle. Aortic Valves,Valve, Aortic,Valves, Aortic
D014261 Tricuspid Valve The valve consisting of three cusps situated between the right atrium and right ventricle of the heart. Tricuspid Valves,Valve, Tricuspid,Valves, Tricuspid
D014262 Tricuspid Valve Insufficiency Backflow of blood from the RIGHT VENTRICLE into the RIGHT ATRIUM due to imperfect closure of the TRICUSPID VALVE. Tricuspid Incompetence,Tricuspid Regurgitation,Tricuspid Valve Incompetence,Tricuspid Valve Regurgitation,Incompetence, Tricuspid,Incompetence, Tricuspid Valve,Insufficiency, Tricuspid Valve,Regurgitation, Tricuspid,Regurgitation, Tricuspid Valve,Valve Incompetence, Tricuspid,Valve Insufficiency, Tricuspid,Valve Regurgitation, Tricuspid
D058385 Cardiac Valve Annuloplasty A type of heart valve surgery that involves the repair, replacement, or reconstruction of the annuli of HEART VALVES. It includes shortening the circumference of the annulus to improve valve closing capacity and reinforcing the annulus as a step in more complex valve repairs. Annular Reduction, Cardiac Valve,Annular Repair, Cardiac Valve,Annulus Reduction, Cardiac Valve,Annulus Repair, Cardiac Valve,Cardiac Valve Annular Reduction,Cardiac Valve Annular Repair,Cardiac Valve Annulus Reduction,Cardiac Valve Annulus Repair,Cardiac Valve Annulus Shortening,Heart Valve Annular Repair,Heart Valve Annuloplasty,Heart Valve Annulus Repair,Valvular Annuloplasty,Annuloplasties, Cardiac Valve,Annuloplasties, Heart Valve,Annuloplasties, Valvular,Annuloplasty, Cardiac Valve,Annuloplasty, Heart Valve,Annuloplasty, Valvular,Cardiac Valve Annuloplasties,Heart Valve Annuloplasties,Valve Annuloplasties, Cardiac,Valve Annuloplasties, Heart,Valve Annuloplasty, Cardiac,Valve Annuloplasty, Heart,Valvular Annuloplasties

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