Impact of cardiac surgery with cardiopulmonary bypass on symptom progression in the early postoperative period in patients with peripheral arterial disease

Abstract

OBJECTIVE: This study aims to examine whether cardiac surgery with cardiopulmonary bypass (CPB) leads to symptom progression in the early postoperative period in patients with the peripheral arterial disease (PAD) undergoing coronary artery bypass grafting surgery (CABG). PATIENTS AND METHODS: This retrospective study included one hundred fifty consecutive adult patients with PAD at Fontaine stage 2b (painfree walking distance less than 100 m) undergoing CABG. The control group comprised 150 consecutive adult patients undergoing CABG with a normal ankle-brachial index (ABI). Symptom progression was defined as the development of ischemic rest pain (Fontaine stage 3). RESULTS: In the first week after surgery, 91 of 150 patients (60.6%) had symptom progression in the PAD group. Rest pain resolved in most of these patients on the 15th postoperative day. At the end of the second month, rest pain resolved in all patients. Logistic regression analysis revealed that ABI (<0.5), CPB time (≥100 mins), nadir hct levels (≤25 %) on CPB, and postoperative nadir hct levels (<25%) were independently associated with postoperative symptom progression. CONCLUSIONS: Our results suggest that cardiac surgery with CPB may lead to symptom progression in patients with severe claudication in the early postoperative period.