Hi, thanks for your question. Amputations in diabetics are quite commonly performed, mainly for limbs that are dangerous (severely infected), or functionless. Regarding your concern about the risk of the operation, the risks can be divided into short and long term complications. short term: 1. bleeding, which can be avoided with careful dissection and ligation 2. anaesthetic risks - this is relevant to your information regarding his ECHO, i/m assuming his ejection fraction is around 15-20% which indicates that his heart reserves is quite limited and he can suffer from low blood pressure leading to a heart attack or a stroke during the operation. These risks are avoided by staying away from blood pressure lowering drugs, performing a regional anaesthetic instead of general anaesthesia etc. I m sure the anaesthesiologist will inform him about their plan of attack to avoid such complications. long term complications: 1. wound breakdown - diabetic have a higher risk of non-healing wounds, I advise for strict control of his blood sugars in the immediate days following the operation 2. phantom pain - a known risk for amputees, having sensation or even pain at the amputated limbs. however, we generally recommend amputation as a last resort and only if the benefits of surgery outweigh the risks. If an infected foot is left alone, the infection can harbour and ascend up, affecting more than just the foot.