Nickel allergy in cardiothoracic surgery: a case report

Background: Metal hypersensitivity represents a rare but important challenge in cardiothoracic surgery, particularly during prosthesis selection for aortic valve replacement. Case Description: A 63-year-old woman with critical bicuspid aortic stenosis and moderate left ventricular dysfunction was found to have severe hypersensitivity to multiple metal alloys, including nickel, palladium, and iridium. Following multidisciplinary evaluation, standard surgical aortic valve replacement was considered unsafe. A transfemoral transcatheter aortic valve implantation using a cobalt–chromium transcatheter valve was successfully performed without complications. Conclusion: This case highlights the importance of individualized, multidisciplinary decision-making when managing patients with significant metal hypersensitivity.