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The Annals of Thoracic Surgery, Vol 47, 182-186, Copyright © 1989 by The Society of Thoracic Surgeons
D Condit and RW Frater
The decision to operate on carriers of the human immunodeficiency virus
(HIV) who need an urgent cardiac operation is difficult. There is a lack of
knowledge about the effect of the presence of HIV on operative risk, about
the effect of cardiopulmonary bypass on the progression of HIV infection to
acquired immunodeficiency syndrome (AIDS), and about the risk to the
cardiac surgical team of operating on 1 or more HIV carriers. This lack of
knowledge is exacerbated by the strict regulations surrounding testing. We
polled the board-certified cardiac surgeons in the United States on their
willingness to perform open cardiac procedures on HIV carriers and AIDS
patients. Fifty-three percent of the surgeons responded. Two thirds of them
will operate on HIV carriers who need an urgent cardiac operation but
regard the presence of AIDS as a contraindication to cardiopulmonary
bypass. This is presumably a medical judgment. Those who will not operate
on HIV carriers are apparently motivated by fear rather than moral
judgments concerning the patients. Virtually all surgeons want to be able
to test "high-risk" patients, and a substantial majority would test all
patients.
ARTICLES
Human immunodeficiency virus and the cardiac surgeon: a survey of attitudes
Albert Einstein College of Medicine, Bronx, New York.
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