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Acute compartment syndrome following cardiovascular surgery: a rare and catastrophic complication highlighting the importance of early detection and intervention
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Acute compartment syndrome following cardiovascular surgery: a rare and catastrophic complication highlighting the importance of early detection and intervention
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Journal Article
Acute compartment syndrome following cardiovascular surgery: a rare and catastrophic complication highlighting the importance of early detection and intervention
2025
Overview
Background
Acute compartment syndrome (ACS) is a critical condition resulting from increased intra-compartmental pressure, causing tissue ischemia and necrosis. ACS following cardiovascular surgery is rare but catastrophic. Postoperative sedation and analgesia often obscure classic symptoms, delaying diagnosis. This underscores the importance of vigilance and early detection, particularly in high-risk scenarios such as prolonged extracorporeal circulation and femoral artery cannulation. Enhanced monitoring, including tissue oxygen saturation and transcutaneous oxygen pressure, may facilitate timely diagnosis.
Case summary
We report a 56-year-old male who developed ACS after valve replacement surgery involving femoral artery cannulation for cardiopulmonary bypass. Approximately 12 h postoperatively, the patient exhibited severe lower limb swelling, mottling, and diminished dorsalis pedis pulse. Laboratory findings revealed elevated myoglobin and creatine kinase levels. Diagnosis was confirmed via clinical and ultrasound evaluation, prompting emergent fasciotomy. Postoperative management included wound care, renal replacement therapy, and skin flap reconstruction. At 6 months follow-up, the patient achieved complete functional recovery of the affected limb.
Conclusion
ACS is a rare but severe complication of cardiovascular surgery. This case highlights the necessity for heightened vigilance, early recognition, and timely intervention to mitigate adverse outcomes. Further studies are needed to validate and establish standardized monitoring protocols and management strategies, including early use of distal perfusion techniques, to improve surgical safety and patient outcomes.
Publisher
BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
Subject
/ Cardiopulmonary Bypass - adverse effects
/ Compartment Syndromes - diagnosis
/ Compartment Syndromes - diagnostic imaging
/ Compartment Syndromes - etiology
/ Compartment Syndromes - physiopathology
/ Compartment Syndromes - surgery
/ Compartment Syndromes - therapy
/ Complications and side effects
/ Creatine
/ Extracorporeal membrane oxygenation
/ Femur
/ Heart Valve Prosthesis Implantation - adverse effects
/ Humans
/ Ischemia
/ Male
/ Medicine
/ Methods
/ Patients
/ Surgery
