Safe Implantation of a Bovine Bioprosthetic Aortic Valve in a Patient With Galactose-α-1,3-Galactose Allergy

Ann Thorac Surg. 2024 Oct;118(4):950-952. doi: 10.1016/j.athoracsur.2024.06.033. Epub 2024 Jul 11.

Abstract

Allergy to galactose-α-1,3-galactose (alpha-gal) is associated with immediate allergic manifestations and premature degeneration of the prosthesis in patients who receive bovine- or porcine-derived bioprosthetic valves. Here, we report a 72-year-old man with atrial fibrillation, aortic regurgitation, and severe alpha-gal allergy who presented for consideration of aortic valve replacement. He was premedicated with antihistamines and steroids and underwent aortic valve replacement with 25-mm INSPIRIS aortic valve (Edwards Lifesciences) and left atrial appendage occlusion with 40-mm AtriClip device (AtriCure), without immediate or short-term complications.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Animals
  • Aortic Valve Insufficiency / etiology
  • Aortic Valve Insufficiency / surgery
  • Aortic Valve* / surgery
  • Bioprosthesis* / adverse effects
  • Cattle
  • Disaccharides
  • Heart Valve Prosthesis Implantation* / adverse effects
  • Heart Valve Prosthesis Implantation* / methods
  • Heart Valve Prosthesis* / adverse effects
  • Humans
  • Hypersensitivity / etiology
  • Male

Substances

  • galactosyl-(1-3)galactose
  • Disaccharides