1.A Case of Ischemic Limb Perfusion during Cardiopulmonary Bypass.
Tomokazu Kosuga ; Shuji Fukunaga ; Kohichi Arinaga ; Kohji Akasu ; Satoru Tobinaga ; Shinsuke Hayashi ; Hidetoshi Akashi ; Takemi Kawara ; Shigeaki Aoyagi
Japanese Journal of Cardiovascular Surgery 1999;28(4):289-292
A 64-year-old woman with chest pain and intermittent claudication was admitted to our hospital. Unstable angina pectoris and arteriosclerosis obliterans (ASO) of both leg were diagnosed. Angiography indicated total occlusion of the right external iliac artery and severe stenosis of the left external iliac artery, in addition to significant stenoses of the three major coronary arteries. The ankle pressure index was 0.49 in her right leg, and 0.74 in the left. Because coronary stenting was unsuccessful, emergency coronary artery bypass grafting was performed prior to arterial reconstruction of the lower extremities. To prevent exacerbation of limb ischemia during cardiopulmonary bypass (CPB), selective limb perfusion was performed with a 14-gauge intravenous catheter inserted into the right superficial femoral artery. There were no complications related to limb ischemia during or after the operation. Selective limb perfusion was considered to be useful to prevent limb ischemia during CPB in patients with ASO of the legs.
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