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Ann Thorac Surg 1989;47:182-186
© 1989 The Society of Thoracic Surgeons

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Articles

Human immunodeficiency virus and the cardiac surgeon: A survey of attitudes

Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA

^_* Address reprint requests to Dr Frater, Division of Cardiothoracic Surgery, Montefiore Medical Center, 111 E 210th St, Bronx, NY 10467.

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.

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