Acute lower extremity ischemia after cardiac surgery

Robert C. Allen, Joe Schneider, Lani Longenecker, Andrzej S. Kosinski, Robert B. Smith, Alan B. Lumsden*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

32 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)124-129
Number of pages6
JournalThe American Journal of Surgery
Issue number2
StatePublished - Jan 1 1993

ASJC Scopus subject areas

  • Surgery


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