Myonephropathic Metabolic Syndrome following Femoral Arterial Cannulation

(Department of Cardiovascular Surgery, National Disaster Medical Center, Tachikawa, Japan)

Saeki Tsukamoto Shoji Shindo Shinsuke Choh
Between 1999 and 2004, 337 cardiovascular surgical procedures using cardiopulmonary bypass were conducted in our institution. Femoral arterial cannulation was performed in 130 cases (38.6%) and 3 of these cases, all men aged under 60, developed compartment syndrome in the ipsilateral leg. The ischemic time of the leg was between 240 and 294 min. Two of them developed myonephropathic metabolic syndrome (MNMS) and underwent continuous hemodiafiltration. Two of the cases were ambulant on discharge from hospital but one died. Compartment syndrome and MNMS are serious complications, and must be prevented rather than treated. Young male patients are at increased risk of these complications, and are often reported in Japan. In order to prevent leg ischemia during femoral cannulation, care should be taken not to disrupt deep femoral arterial flow (which is the collateral inflow) or superficial femoral arterial flow. When back flow from the profunda femoris artery is inadequate, peripheral perfusion should be performed to avoid leg ischemia..
@Jpn. J. Cardiovasc. Surg. 35: 136-139 (2006)