Urgent replacement of a mechanical mitral prosthesis in an anticoagulated patient with Bombay red blood cell phenotype

Bombay red blood cell phenotype is an extremely rare blood type for which patients can receive only autologous or Bombay phenotype red blood cells. We report a case of stenotic mitral valve with Bombay phenotype who underwent minimal invasive right lateral thoracotomy for the replacement of the mitral valve. A male patient from Bangladesh presented to the hospital with New York Heart Association III symptoms. His medical evaluation revealed severe mitral valve stenosis and mild aortic valve regurgitation. The patient received erythropoietin, intravenous iron succinate and folic acid tablets. Autologous blood transfusion was carried out. The mitral valve was replaced with a prosthetic valve successfully. After weaning off from cardiopulmonary bypass, heparinisation was corrected with protamine. Post-operatively, the patient received autologous red blood cells. The patient recovered after 1-day of inotropic support with adrenaline and milrinone, and diuretics and was discharged on the 5th post-operative day.

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“…However, all patients with type O blood, including Bombay phenotype, have been described with higher rates of bleeding complications. [ 6 ]…”

Section: Discussionmentioning

confidence: 99%

Perioperative management of patient with Bombay blood group undergoing mitral valve replacement

et al. 2015

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“…As clinical practice continues to advance in these areas, physicians involved in treating critically ill patients may encounter individuals with "rare blood types," either in the perioperative period or in the operating room. These rare blood types may represent a significant impediment to both urgent and planned transfusion of red blood cells (RBCs) and pose significant administrative and clinical challenges for the practitioner [3]. Clinical guidelines do not address management of these patients [1].…”

Section: Introductionmentioning

confidence: 99%