TAVR Patients With Nickel Allergy

Transcatheter aortic valve replacement (TAVR) is a preferred treatment option for many patients with severe aortic stenosis, but concerns exist regarding safety in patients with nickel allergy due to metallic valve frames. We report a series of 7 patients with a history of nickel allergy who underwent TAVR. Preprocedural allergy evaluation varied, including patch testing or direct skin contact with valve fragments. None of the patients experienced severe allergic reactions, and all remained free of significant nickel allergy-related symptoms during follow-up. A review of the literature identified only 1 prior case of severe nickel hypersensitivity requiring TAVR valve explantation. Importantly, no consistent correlation was observed between patch test results and clinical outcomes. These findings suggest that TAVR can likely be safely performed in patients with nickel allergy and that routine preprocedural patch testing has questionable utility. Further research is needed to clarify long-term outcomes in this population.