title: [Leg amputation for severe lower limb ischemia caused by type A acute aortic dissection; report of a case].
abstract: A 41-year-old man underwent total arch replacement and aorto-bifemoral bypass owing to type A acute aortic dissection complicated by ischemia of both lower extremities. Just after the operation, he developed myonephropathic metabolic syndrome due to severe ischemia of the right leg, and hemodiafiltration was performed. However, the serum potassium was elevated to an uncontrollable level. Ligation of the right femoral artery and the right branch of the bypass graft was performed one hour after the transfer to intensive care unit (ICU), and the serum potassium dropped to a normal level. He underwent amputation of the right lower limb above the knee on the 13th postoperative day, and was discharged after long-term rehabilitation.
authors.affiliation: Department of Thoracic Surgery, Tohoku Pharmaceutical University Hospital, Sendai, Japan.
authors.forename: Suguru
authors.initials: S
authors.lastname: Watanabe
authors.forename: Tadanori
authors.initials: T
authors.lastname: Minagawa
authors.forename: Hidenori
authors.initials: H
authors.lastname: Fujiwara
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kanda
authors.forename: Makoto
authors.initials: M
authors.lastname: Miura
authors.forename: Koichi
authors.initials: K
authors.lastname: Tabayashi
mesh_terms: D000208:Acute Disease; D000328:Adult; D000671:Amputation, Surgical; D000784:Aortic Dissection / Q000150:complications*; D017544:Aortic Aneurysm, Abdominal / Q000150:complications*; D006801:Humans; D007511:Ischemia / Q000209:etiology* / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male