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Updated: Sep 22, 2025

High-Resolution Three-Dimensional Imaging of the Footpad Vasculature in a Murine Hindlimb Gangrene Model
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Gangrene of the Foot After Coronary Artery Bypass Graft Surgery

Julia L Boland1,2, Kristine Cueva2, Jessica Pawly2

  • 1Department of Internal Medicine, George Washington University Hospital, Washington DC, USA.

The Permanente Journal
|May 24, 2022
PubMed

Insights

A rare complication of coronary artery bypass grafting (CABG) with intra-aortic balloon pump (IABP) use led to dry gangrene and amputation. Prompt diagnosis and treatment are crucial for managing this serious post-operative outcome.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery
  • Medical Case Reports

Background:

  • Coronary artery bypass grafting (CABG) is a common cardiothoracic procedure.
  • Intra-aortic balloon pump (IABP) may be used perioperatively to support cardiac function.
  • Potential CABG risks include neurological issues, thrombosis, organ injury, and mortality.

Observation:

  • A 75-year-old man with myocardial infarction required IABP support before CABG.
  • Eighteen days post-CABG, the patient developed dry gangrene of the toes.
  • CT angiogram revealed severe atherosclerosis and occlusive lesions in lower limb arteries.

Findings:

  • The patient underwent balloon angioplasty and transmetatarsal amputation for dry gangrene.
  • Aortic atherosclerosis and infrapopliteal occlusive disease were identified as contributing factors.
  • This case highlights a rare complication associated with CABG and peri-operative IABP.

Implications:

  • Emphasizes the importance of recognizing and promptly treating dry gangrene following CABG with IABP.
  • Suggests a need for thorough vascular assessment in patients with post-operative ischemic complications.
  • Underscores the multifaceted risks associated with complex cardiac surgeries and interventions.

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