Cardiac Surgery and the Human Immunodeficiency Virus

  • N. Bonnet
  • P. Leprince
  • S. Varnous
  • I. Gandjbakhch


Twenty years after the first antibody test for the human immunodeficiency virus (HIV), highly active antiretroviral therapy (HAART) became available in Western countries. Although cardiac surgery in HIV-infected patients remains rare — 0.2% of interventions with extracorporeal circulation (ECC) in La Pitié Institute — and has some particularities, the majority of cardiac surgeons believe that the surgical strategies and techniques should be the same for HIV-infected patients as for other patients.


Human Immunodeficiency Virus Human Immunodeficiency Virus Infection Infective Endocarditis Pericardial Effusion Human Immunodeficiency Virus Testing 
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  1. 1.
    Frater RW, Sisto D, Condit D (1989) Cardiac surgery in human immunodeficiency virus (HIV) carriers. Eur J Cardiothorac Surg 3:146–150CrossRefPubMedGoogle Scholar
  2. 2.
    Frater RW (1999) As originally published in 1989: human immunodeficiency virus and the cardiac surgeon: a survey of attitudes. Updated in 1999. Ann Thorac Surg 67:1203–1204CrossRefGoogle Scholar
  3. 3.
    Frater RW (2000) Cardiac surgery and the human immunodeficiency virus. Semin Thorac Cardiovasc Surg 12:145–147PubMedGoogle Scholar
  4. 4.
    Abad C, Cardenes MA, Jimenez PC et al (2000) Cardiac surgery in patients infected with human immunodeficiency virus. Tex Heart Inst J 27:356–360PubMedGoogle Scholar
  5. 5.
    Everson D, Zeigler R, Sabbaga AM et al (1999) Significance of the human immunodeficiency infection in patients submitted to cardiac surgery. J Cardiovasc Surg 40:477–479Google Scholar
  6. 6.
    Palella FJ Jr, Delaney KM, Moorman AC et al (1998) Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV Outpatient Study Investigators. N Engl J Med 338:853–860Google Scholar
  7. 7.
    Trachiotis GD, Alexander EP, Benator D, Gharagozloo F (2003) Cardiac surgery in patients infected with the human immunodeficiency virus. Ann Thorac Surg 76(4):1114–1118CrossRefPubMedGoogle Scholar
  8. 8.
    Mestres CA, Chuquire JE, Claramonte X et al (2003) Long-term results after cardiac surgery in patients infected with the human immunodeficiency virus type-1 (HIV-1). Eur J Cardiothorac Surg 23:1007–1016CrossRefPubMedGoogle Scholar
  9. 9.
    Heidenreich PA, Eisenberg MJ, Kee LL et al (1995) Pericardial effusion in AIDS, incidence and survival. Circulation 92:3229–3234PubMedGoogle Scholar
  10. 10.
    Cegielski JP, Ramiya K, Lallinger GJ et al (1990) Pericardial disease and human immunodeficiency virus in Dar es Salaam, Tanzania. Lancet 335:209–212CrossRefPubMedGoogle Scholar
  11. 11.
    Holtz H, Lavery D, Kapila R (1985) Actinomycetales infection in AIDS. Ann Intern Med 102:203–205PubMedGoogle Scholar
  12. 12.
    Schuster M, Valentine F, Holzman R (1985) Cryptococcal pericarditis in an intravenous drug abuser. J Infect Dis 152:842PubMedGoogle Scholar
  13. 13.
    Stotka JL, Good CB, Downer WR, Kapoor WN (1989) Pericardial effusion and tamponade due to Kaposi’s sarcoma in acquired immunodeficiency syndrome. Chest 95:1359–1361CrossRefPubMedGoogle Scholar
  14. 14.
    Holladay AO, Siegel RJ, Schwartz DA (1992) Cardiac malignant lymphoma in acquired immune deficiency syndrome. Cancer 70:2203–2207CrossRefPubMedGoogle Scholar
  15. 15.
    Karve MM, Murali MR, Shah HM, Phelps KR (1992) Rapid evolution of cardiac tamponade due to bacterial pericarditis in two patients with HIV-1 infection. Chest 101:1461–1463CrossRefPubMedGoogle Scholar
  16. 16.
    Kwan T, Kwan MM, Emerole O (1993) Cardiac tamponade in patients infected with HIV: a report from an inner-city hospital. Chest 104:1059–1062CrossRefPubMedGoogle Scholar
  17. 17.
    Carrel T, Schaffner A, Vogt P et al (1993) Endocarditis in intravenous drug addicts and HIV infected patients: possibilities and limitations of surgical treatment. J Heart Valve Dis 2:140–147PubMedGoogle Scholar
  18. 18.
    De Rosa FG, Cicalini S, Canta F et al (2007) Infective endocarditis in intravenous drug users from Italy: the increasing importance in HIVinfected patients. Infection 35:154–160CrossRefPubMedGoogle Scholar
  19. 19.
    Gebo KA, Burkey MD, Lucas GM et al (2006) Incidence of, risk factors for, clinical presentation, and 1-year outcomes of infective endocarditis in an urban HIV cohort. J Acquir Immune Defic Syndr 43:426–432CrossRefPubMedGoogle Scholar
  20. 20.
    Aris A, Pomar JL, Saura E (1993) Cardiopulmonary bypass in HIV-positive patients. Ann Thorac Surg 55:1104–1107PubMedGoogle Scholar
  21. 21.
    Barbarini G, Barbaro G (2003) Incidence of the involvement of the cardiovascular system in HIV infection. AIDS 17(Suppl 1):S46–S50Google Scholar
  22. 22.
    Nahass RG, Weinstein MP, Bartels J, Gocke DJ (1990) Infective endocarditis in intravenous drug users: a comparison of human immunodeficiency virus type 1-negative and-positive patients. J Infect Dis 162:967–970PubMedGoogle Scholar
  23. 23.
    Mestres CA, Castella M, Moreno A et al; Hospital Clinico Endocarditis Study Group (2006) Cryopreserved mitral homograft in the tricuspid position for infective endocarditis: a valve that can be repaired in the long-term (13 years). J Heart Valve Dis. 15:389–391PubMedGoogle Scholar
  24. 24.
    Friis-Moller N, Reiss P, Sabin CA et al; the DAD Study Group (2007). Class of antiretroviral drugs and the risk of myocardial infarction. N Engl J Med 356:1723–1735CrossRefPubMedGoogle Scholar
  25. 25.
    Flum DR, Tyras DH, Wallack MK (1997) Coronary artery bypass grafting in patients with human immunodeficiency virus. J Card Surg 12:98–101CrossRefPubMedGoogle Scholar
  26. 26.
    Filsoufi F, Salzberg SP, Harbou KT et al (2006). Excellent outcomes of cardiac surgery in patients infected with HIV in the current era. Clin InfectDis 43:532–536CrossRefGoogle Scholar
  27. 27.
    Sousa Uva M, Jebara VA, Fabiani JN et al (1992) Cardiac surgery in patients with human immunodeficiency virus infection: indication and results. J Card Surg 7:204–204Google Scholar
  28. 28.
    Ragni MV, Dodson SF, Hunt SC et al (1999) Liver transplantation in a hemophilia patient with acquired immunodeficiency syndrome. Blood 93:113–114Google Scholar
  29. 29.
    Roland ME, Stock PG (2003) Review of solidorgan transplantation in HIV-infected patients. Transplantation 75:425–429CrossRefPubMedGoogle Scholar
  30. 30.
    Halpern SD, Ubel PA, Caplan AL (2002) Solidorgan transplantation in HIV-infected patients. N Engl J Med 347:284–287CrossRefPubMedGoogle Scholar
  31. 31.
    Bisleri G, Morgan J, Deng M et al (2003) Should HIV-positive recipients undergo heart transplantation? J Thorac Cardiovasc Surg 126:1639–1640CrossRefPubMedGoogle Scholar
  32. 32.
    Calabrese LH, Albrecht M, Young Y et al (2003) Successful cardiac transplantation in an HIV-1-infected patient with advanced disease. N Engl J Med 348:2323–2328CrossRefPubMedGoogle Scholar
  33. 33.
    Jahangiri B, Haddad H (2007) Cardiac transplantation in HIV-positive patients: Are we there yet? J Heart Lung Transplant 26:103–107CrossRefPubMedGoogle Scholar
  34. 34.
    Tzakis AG, Cooper MH, Dummer JS et al (1990) Transplantation in HIV(+) patients. Transplantation 49:354–358CrossRefPubMedGoogle Scholar
  35. 35.
    Henderson DK (1997) Postexposure antiretroviral chemoprophylaxis: embracing risk for safety’s sake. N Engl J Med 337:1542–1543CrossRefPubMedGoogle Scholar
  36. 36.
    Beekman SE, Vlahov D, Koziol DE et al (1994) Implementation of universal precautions was temporally associated with a sustained progressive decrease in percutaneous exposures to blood or body fluids. Clin Infect Dis 18:562–569Google Scholar
  37. 37.
    Klatt EC (1994) Surgery and human immunodeficiency virus infection: indications, pathologic findings, risks, and risk prevention. Int Surg 79:1–5PubMedGoogle Scholar
  38. 38.
    Tanner J, Parkinson H (2004) Double gloving to reduce surgical cross-infection (Cochrane Review). In: The Cochrane Library, issue 3. Wiley, Chichester, NYGoogle Scholar
  39. 39.
    Kendall JB, Hart CA, Pennefather SH, Russel GN (2003) Infection control measures for adult cardiac surgery in the UK: a survey of current practice. J Hosp Infect 54:174–178CrossRefPubMedGoogle Scholar
  40. 40.
    Kjaegard HK, Thiis J, Wiinberg N (1992) Accidental injuries and blood exposure to cardiothoracic surgical teams. Eur J Cardiothorac Surg 6:215–217CrossRefGoogle Scholar
  41. 41.
    Nelson KE, Donahue JG, Munoz A et al (1992) Transmission of retroviruses from seronegative donors by transfusion during cardiac surgery: a multicenter study of HIV-1 and HTLV-I/II infections. Ann Intern Med 117:612–614Google Scholar
  42. 42.
    Cohen ND, Munoz A, Reitz BA et al (1989) Transmission of retroviruses by transfusion of screened blood in patients undergoing cardiac surgery. N Engl J Med 320:1172–1176PubMedCrossRefGoogle Scholar
  43. 43.
    Pillonel J, Laperche S, Groupe “Agents Transmissibles par Transfusion” de la Societe francaise de transfusion sanguine, Etablissement francais du sang, Centre de transfusion sanguine des armees (2004) Risque résiduel de transmission du VIH, du VHC et du VHB par transfusion sanguine entre 1992 et 2002 en France et impact du dépistage génomique viral. Transfus Clin Biol 11:81–86Google Scholar
  44. 44.
    Solheim BG, Rollag H, Svennevig JL et al (2000) Viral safety of solvent/detergent-treated plasma. Transfusion 40:1149–1150CrossRefGoogle Scholar
  45. 45.
    Tanaka K, Waly A, Cooper W, Levy J (2003) Treatment of excessive bleeding in Jehovah’s Witness patients after cardiac surgery with recombinant factor VIIa (NovoSeven). Anesthesiology 98:1513–1515CrossRefPubMedGoogle Scholar
  46. 46.
    King SM, Murphy T, Corey M et al (1995) The HIV information project: transfusion recipients a decade after transfusion. Arch Pediatr Adolesc Med 149:680–685PubMedGoogle Scholar
  47. 47.
    Babinchak TJ, Renner C (1994) Patients treated by thoracic surgeon with HIV: a review. Chest 106:681–683CrossRefPubMedGoogle Scholar
  48. 48.
    Lemma M, Vanelli P, Beretta L et al (1992) Cardiac surgery in HIV-positive intravenous drug addicts: influence of cardiopulmonary bypass on the progression to AIDS. Thorac Cardiovasc Surg 40:279–282CrossRefPubMedGoogle Scholar
  49. 49.
    Vasseur BG, Kawanishi H, Shah N, Anderson ML (2002) Type B lactic acidosis: a rare complication of antiretroviral therapy after cardiac surgery. Ann Thorac Surg 74:1251–1252CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 2009

Authors and Affiliations

  • N. Bonnet
    • 1
  • P. Leprince
    • 1
  • S. Varnous
    • 1
  • I. Gandjbakhch
    • 1
  1. 1.Service de Chirurgie Cardio-vasculaire et ThoraciqueInstitut de Cardiologie, Groupe Hospitalier Pitié-SalpêtrièreParisFrance

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