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

D Condit1, R W Frater

  • 1Albert Einstein College of Medicine, Bronx, New York.

The Annals of Thoracic Surgery
|February 1, 1989
PubMed

Insights

Most cardiac surgeons will operate on human immunodeficiency virus (HIV) carriers needing urgent surgery but avoid operating on acquired immunodeficiency syndrome (AIDS) patients. Surgeons cite fear and desire for universal patient testing.

Area of Science:

  • Cardiovascular Surgery
  • Infectious Diseases
  • Public Health

Background:

  • Difficult decisions arise when operating on human immunodeficiency virus (HIV) carriers requiring urgent cardiac surgery.
  • Uncertainty exists regarding HIV's impact on surgical risk, cardiopulmonary bypass effects on HIV progression to acquired immunodeficiency syndrome (AIDS), and surgical team safety.
  • Strict testing regulations compound the knowledge gap.

Purpose of the Study:

  • To assess US board-certified cardiac surgeons' willingness to operate on HIV carriers and AIDS patients.
  • To understand the factors influencing these surgical decisions.

Main Methods:

  • A survey was distributed to board-certified cardiac surgeons across the United States.
  • The survey queried their stance on performing open cardiac procedures on HIV carriers and AIDS patients.
  • Response rate was 53%.

Main Results:

  • Two-thirds of responding surgeons would operate on HIV carriers needing urgent cardiac operations.
  • The majority consider acquired immunodeficiency syndrome (AIDS) a contraindication for cardiopulmonary bypass.
  • Surgeons unwilling to operate on HIV carriers appear motivated by fear, not moral objections.

Conclusions:

  • A significant portion of cardiac surgeons are willing to operate on HIV carriers, but AIDS presence influences their decision regarding cardiopulmonary bypass.
  • Fear, rather than ethical concerns, seems to drive refusal to operate on HIV carriers.
  • Most surgeons desire the ability to test high-risk patients, with a majority favoring universal patient testing.

Keywords:
Empirical ApproachHealth Care and Public HealthProfessional Patient Relationship

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