Cardiac surgery in patients with major lower extremity amputation: a single institution experience.
BACKGROUND
Cardiac surgery patients with lower-extremity amputations pose a challenge in terms of medical comorbidities and functional recovery.


METHODS
A retrospective review of all patients (n=10) with preexisting below-knee amputation (BKA) or more proximal amputation level who underwent cardiac surgery between April 1998 and April 2008. Data were analyzed to evaluate outcomes.


RESULTS
The median age was 59 y (range, 51-75 y). One patient had bilateral above-knee amputation (AKA), and 9 had BKAs (two bilateral). Comorbidities included diabetes (n=5), peripheral vascular disease (n=7), cerebrovascular disease (n=2), hypertension (n=9), chronic renal insufficiency (n=2), pulmonary hypertension (n=1), and pulmonary fibrosis (n=1). Nine patients underwent coronary artery bypass grafting and one patient underwent aortic valve replacement. There were no operative deaths. The median length of hospital stay (to home discharge) was 12.5 d (range, 5-562 d). Eight patients were transferred to a rehabilitation unit or a chronic care facility before being discharged to home. At follow-up (median, 1.5 y; range, 0.4-3.8 y), all but one patient were alive and had returned to their preoperative ambulatory status.


CONCLUSIONS
In our experience, patients with lower-extremity amputations require prolonged hospitalization after cardiac surgery but can expect good mid-term outcomes and functional recovery.
Bakaeen
Faisal G
FG
Baylor College of Medicine, Michael E DeBakey Veterans Affairs Medical Center, Texas Heart Institute at St Luke's Episcopal Hospital, Houston, TX 77030, USA. fbakaeen@bcm.edu
Chu
Danny
D
Chi
Casiano
C
Lin
Peter H
PH
Kougias
Panagiotis
P
Hawes
Luke
L
LeMaire
Scott A
SA
Coselli
Joseph S
JS
Huh
Joseph
J
D000368:Aged; D000674:Amputees; D006348:Cardiac Surgical Procedures / Q000534:rehabilitation*; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome