A Case of Mitral Valve Stenosis and Tricuspid Valve Regurgitation Accompanied by Metal Allergy Treated with Mitral Valve Replacement and Tricuspid Valve Annuloplasty

(Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, Japan)

Yu Shomura Yukikatsu Okada Michihiro Nasu
Hiroshi Fujiwara Shigeru Komori Mikito Inouchi
Yasuhisa Ozu Takashi Hashimoto
A 66-year-old woman who had percutaneous mitral valve commissurotomy 12 years before was admitted complaining of dyspnea on effort. Echocardiography showed severe mitral stenosis and regurgitation, and moderate tricuspid regurgitation associated with atrial fibrillation. Based on her past history we suspected allergy to metal, and skin patch tests showed a positive reaction to zinc, manganese, nickel, cobalt, dichromate, stainless steel, titanium alloys, and nickel-chromium-cobalt alloys. We selected an artificial organ which would not cause an allergic reaction. The St. Jude Medical standard cuff mechanical valve was the only compatible prosthetic valve. Anterolateral right thoracotomy, instead of median sternotomy, was selected. Mitral valve replacement with a 27-mm St. Jude Medical standard cuff mechanical valve and tricuspid valve annuloplasty with a 27-mm Duran flexible band were performed. Her postoperative course was uneventful. She is doing well without any allergic symptom 18 months after the surgery.
  Jpn. J. Cardiovasc. Surg. 38:385-388(2009)

Keywords:metal allergy, prosthetic valve, prosthetic ring for annuloplasty, patch test