A 70-year-old woman with a history of bypass surgery for coarctation of the aorta (CoA) at approximately 10 years of age was referred to our hospital after a descending thoracic aortic aneurysm was discovered during a preoperative examination for uterine cancer. Contrast-enhanced CT revealed a 62×47 mm aneurysm in the descending thoracic aorta, connected to the bypass vessel, leading to the diagnosis of an anastomotic pseudoaneurysm following CoA surgery. Due to the large diameter of the aortic aneurysm and the high risk of rupture, we performed a left axillary artery to left femoral artery bypass in addition to thoracic endovascular aortic repair (TEVAR). Postoperative CT indicated no endoleak, and the patient was discharged after uterine cancer surgery with an uneventful recovery.

We present a successful case of a patient with multiple metal allergy—cobalt, nickel, chromium, and zinc—who had a past history of systemic metal dermatitis. He was a 58-year-old man who complained of exertional chest discomfort. After admission, he had a fever and his blood culture was positive with methicillin-sensitive Staphylococcus aureus. Three days later, multiple micro cerebral infraction was detected in magnetic resonance imaging. After an improvement of inflammatory reaction, he was transferred to our facility for cardiac examination. Moderate mitral regurgitation due to valve perforation and multiple coronary vessel stenosis were detected. Mitral valve replacement and coronary artery bypass grafting were planned to perform. We chose surgical materials based on a preoperative epicutaneous (patch) test and his clinical course was uneventful without any allergic reaction. Metal contact allergy is an important issue in cardiovascular surgery. A collaboration with dermatologists is essential for the preparation of surgical materials.