Autoimmune Reaction and the Management of Recurrent Bioprosthetic Pulmonary Valve Dysfunction.

BACKGROUND

Bioprosthetic valve failure is a significant and debilitating sequela in cardiac patients caused primarily by structural changes in valve leaflets due to endocarditis, calcification, and thrombosis.

CASE SUMMARY: We describe a rare case of bioprosthetic pulmonary valve failure due to an allergic reaction to molybdenum within the valve cage. We describe the clinical presentation, clinical methods leading to the diagnosis, and treatment progression until we could resolve symptoms and a significant return of valvular competency.

DISCUSSION: After excluding infectious etiologies as a cause, we used skin allergy testing to identify molybdenum as the allergic agent. The patient's symptoms and valve function improved and stabilized with immunosuppression and antihistamines.

TAKE-HOME MESSAGES: Allergy to a valve metal component was diagnosed with skin allergy and treated with immunosuppression and antihistamines.