Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.
Cardiac surgery in human immunodeficiency virus (HIV) carriers.
Eur J Cardiothorac Surg. 1989;3(2):146-50; discussion 150-1. Unique Identifier : AIDSLINE MED/90180899 Frater RW; Sisto D; Condit D; Department of Cardiothoracic Surgery, Albert Einstein College of; Medicine, Bronx, NY.
Abstract:
Intravenous drug addicts have always been at risk for acquiring infective endocarditis. In the United States in recent years, as many as 50% of addicts have become infected also with the human immunodeficiency virus (HIV). Since testing became available in late 1984, we have knowingly performed open cardiac surgery for endocarditis 11 times in HIV-positive patients. In 7, signs of infection were still presented at the time of surgery. Four died within 2 months of continued or recurrent sepsis. The others are alive, although 1 has returned to IV drug abuse. Open heart surgery was performed 4 times in patients whose endocarditis had been cured by antibiotics but who were left with destroyed valves and severe congestive cardiac failure. All these patients left hospital alive and well. One has since died of AIDS. Ten addicts with endocarditis coming to surgery in the pre-AIDS era had similar valvular pathology but only 2 with uncontrolled infection. All were cured by the combination of antibiotics and surgery. Conclusions: in HIV-positive patients with endocarditis, continued sepsis despite appropriate antibiotic therapy signals a potentially very serious prognosis which may be due to an already seriously impaired immune state. By contrast, in the absence of uncontrolled infection, HIV-positive patients appear to have a normal response to open cardiac surgery. Data on the risk to the patient of progressing to AIDS and the risk to the surgical team of acquiring HIV infection are unknown. Testing is vital for answering these questions.
Keywords: Acquired Immunodeficiency Syndrome/*TRANSMISSION Aortic Valve Endocarditis, Bacterial/ETIOLOGY/*SURGERY *Heart Valve Prosthesis Human *HIV Seropositivity Male Mitral Valve Risk Factors Staphylococcal Infections/ETIOLOGY/*SURGERY Substance Abuse, Intravenous/*COMPLICATIONS Tricuspid Valve JOURNAL ARTICLE 900630
M9060578
AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.
Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.
