A fifty seven-year-old man visited the
outpatient department with
chest pain and claudication. Coronary
angiogram showed
coronary artery diseases (3-vessel
diseases ) and CABG was planned. However,
lower extremity angiogram showed
stenosis of both common
iliac arteries and
stent implantation of both
iliac arteries were done before CABG. He underwent CABG and IABP was inserted for
weaning from
cardiopulmonary bypass . After CABG, ischemic change on ends of
feet was noted with red-brown colored
urine and
hyperkalemia .
Blood myoglobin level was over 3,000 ng/ml. Microembolism of his lower body was revealed by multiple uptakes on the whole body
bone scan study. After management by massive hydration and
alkalization of
urine with
sodium bicarbonate , he was recovered without
renal replacement therapy and discharged in good condition.