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Acute lower extremity ischemia after cardiac surgery
R C Allen1, J Schneider, L Longenecker
1Department of Surgery, Emory University Hospital, Atlanta, Georgia.
American Journal of Surgery
|August 1, 1993
Summary
Acute leg ischemia following cardiac surgery is rare but serious, leading to high morbidity and mortality. Early diagnosis and treatment are crucial, though limb salvage does not impact overall patient survival.
Area of Science:
- Vascular Surgery
- Cardiology
- Critical Care Medicine
Background:
- Major cardiac surgery carries risks, including rare but severe complications like acute leg ischemia.
- Leg ischemia post-cardiac surgery is associated with significant patient morbidity and mortality.
Purpose of the Study:
- To review the incidence, diagnosis, treatment, and outcomes of acute leg ischemia in patients undergoing major cardiac surgery.
- To identify factors influencing morbidity and mortality in this patient population.
Main Methods:
- Retrospective review of 7,620 major cardiac surgery procedures over a 5-year period (1987-1992).
- Identification of 65 patients (0.85%) who developed acute leg ischemia.
- Analysis of diagnostic methods, treatment strategies, and patient outcomes.
Main Results:
- Acute leg ischemia occurred in 0.85% of patients, with diagnosis primarily by physical examination (97%).
- Intra-aortic balloon pump (IABP) was used in 86% of affected patients.
- High rates of morbidity (92%) and mortality (46%) were observed; mortality was lower (11%) in patients without IABP.
Conclusions:
- Acute leg ischemia after cardiac surgery is a critical complication linked to compromised cardiac status and multi-system disease.
- Treatment is tailored to patient condition, arterial insufficiency, and peripheral vascular disease.
- Limb salvage did not influence overall patient survival in this cohort.