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Acute lower extremity ischemia after cardiac surgery.

Publication ,  Journal Article
Allen, RC; Schneider, J; Longenecker, L; Kosinski, AS; Smith, RB; Lumsden, AB
Published in: Am J Surg
August 1993

A retrospective review during a 5-year period (1987 to 1992) was conducted of all patients manifesting leg ischemia after major cardiac surgery. There were 7,620 procedures performed, and 65 (0.85%) patients (mean age: 65 years) were identified with acute ischemia. Diagnosis was made by physical examination, during which a cool pulseless extremity without pedal Doppler signals was noted in 63 of 65 patients (97%). An intra-aortic balloon pump (IABP) was inserted in 56 patients (86%). Treatment regimens included medical management (17), IABP removal (4), IABP removal and thromboembolectomy (24), thromboembolectomy and endarterectomy with patch angioplasty (10), femoral-femoral bypass (17), other bypasses (6), fasciotomy (10), and amputation (16). Morbidity was 92% and mortality was 46%. Mortality was 11% in those patients developing ischemia without an IABP. Acute leg ischemia after cardiac surgery is predictive of high morbidity and mortality. This reflects the compromised cardiac status and multi-system disease. Treatment alternatives are based on the overall clinical status, degree of arterial insufficiency, and distribution of pre-existing peripheral vascular disease. However, ultimate limb salvage had no influence on overall patient survival in our study.

Duke Scholars

Published In

Am J Surg

DOI

ISSN

0002-9610

Publication Date

August 1993

Volume

166

Issue

2

Start / End Page

124 / 129

Location

United States

Related Subject Headings

  • Surgery
  • Retrospective Studies
  • Postoperative Complications
  • Middle Aged
  • Male
  • Leg
  • Ischemia
  • Intra-Aortic Balloon Pumping
  • Humans
  • Heart Valve Prosthesis
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Allen, R. C., Schneider, J., Longenecker, L., Kosinski, A. S., Smith, R. B., & Lumsden, A. B. (1993). Acute lower extremity ischemia after cardiac surgery. Am J Surg, 166(2), 124–129. https://doi.org/10.1016/s0002-9610(05)81042-6
Allen, R. C., J. Schneider, L. Longenecker, A. S. Kosinski, R. B. Smith, and A. B. Lumsden. “Acute lower extremity ischemia after cardiac surgery.Am J Surg 166, no. 2 (August 1993): 124–29. https://doi.org/10.1016/s0002-9610(05)81042-6.
Allen RC, Schneider J, Longenecker L, Kosinski AS, Smith RB, Lumsden AB. Acute lower extremity ischemia after cardiac surgery. Am J Surg. 1993 Aug;166(2):124–9.
Allen, R. C., et al. “Acute lower extremity ischemia after cardiac surgery.Am J Surg, vol. 166, no. 2, Aug. 1993, pp. 124–29. Pubmed, doi:10.1016/s0002-9610(05)81042-6.
Allen RC, Schneider J, Longenecker L, Kosinski AS, Smith RB, Lumsden AB. Acute lower extremity ischemia after cardiac surgery. Am J Surg. 1993 Aug;166(2):124–129.
Journal cover image

Published In

Am J Surg

DOI

ISSN

0002-9610

Publication Date

August 1993

Volume

166

Issue

2

Start / End Page

124 / 129

Location

United States

Related Subject Headings

  • Surgery
  • Retrospective Studies
  • Postoperative Complications
  • Middle Aged
  • Male
  • Leg
  • Ischemia
  • Intra-Aortic Balloon Pumping
  • Humans
  • Heart Valve Prosthesis