Perioperative Outcomes After Bioprosthetic Valve Replacement In Patients Sensitized To Alpha-Gal

BACKGROUND Alpha-gal syndrome (AGS) from tick bites, due to sensitivity to alpha-gal, can cause severe allergies. Heart valve implants contain alpha-gal, yet AGS screening isn't standard before valve replacement. This study examines perioperative outcomes in patients with alpha-gal antibodies. METHODS This is a single-institution prospective cohort study of patients undergoing bioprosthetic aortic valve replacement between January 2022 and January 2023. Anti-alpha-gal IgE levels were measured, with primary outcomes being severe allergic reactions and in-hospital mortality, and secondary outcomes including ICU and hospital stay. RESULTS Of 155 patients, 32.7% (n = 19) of surgical aortic valve replacement (SAVR) and 29.9% (n = 29) of transcatheter aortic valve replacement (TAVR) patients had detectable IgE levels without subsequent serious allergic reactions or in-hospital mortality. Postoperative hospital stay and valve function were similar across groups. CONCLUSIONS In this study, sensitization to alpha-gal was not associated with serious allergic reactions and did not affect immediate aortic valve function after SAVR or TAVR.