Lower limb amputation of the donor site extremity after coronary artery bypass graft surgery

A 68-year-old man with peripheral vascular disease and diabetes mellitus underwent coronary artery bypass graft surgery for angina pectoris unresponsive to medical treatment. Postoperatively, the left saphenous vein donor site became infected and developed a nonhealing ulcer. Three months after surgery, a left below-knee amputation was performed. The patient's prosthetic program was uneventful, and he became independent in ambulation with a prosthesis. This rare complication of coronary artery bypass graft surgery may be prevented by careful preoperative evaluation of peripheral circulation of the proposed donor site and consideration of alternative donor sites, such as the internal mammary artery. To our knowledge, this is the first detailed description and second reported case of lower limb amputation of the donor site extremity following such surgery.