title: Cardiac surgery in patients with major lower extremity amputation: a single institution experience.
abstract: 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.
authors: 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
authors: Faisal G
authors: FG
authors: Bakaeen
authors: Danny
authors: D
authors: Chu
authors: Casiano
authors: C
authors: Chi
authors: Peter H
authors: PH
authors: Lin
authors: Panagiotis
authors: P
authors: Kougias
authors: Luke
authors: L
authors: Hawes
authors: Scott A
authors: SA
authors: LeMaire
authors: Joseph S
authors: JS
authors: Coselli
authors: Joseph
authors: J
authors: Huh
mesh_terms: 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