Cardiac surgery in patients infected with human immunodeficiency views

From January 1991 through December 1999 5 consecutive patients who were inf ected with human immunodeficiency virus presented in need of cardiac surger y. Ali were men; the median age was 44 years. Two of them presented with mi tral and aortic infectious valve endocarditis, 1 with tricuspid endocarditi s, 1 with prosthetic valve endocarditis, and 1 with pericarditis and perica rdial tamponade. Under cardiopulmonary bypass, the 4 patients with endocarditis underwent th ese procedures. mitral and aortic valve replacement (2), tricuspid valve re placement (1), and aortic valve replacement (reoperation) and concomitant r epair of a mycotic ascending aortic aneurysm (1). In the patient who had pe ricardial effusion, subxifoid pericardiostomy and drainage were performed, and a pericardial window was created There was no intraoperative mortality The patient with pericardial effusion died 8 days after surgery; he was in septic shock and had multiple organ failure. Two deaths occurred at 2 and 6 3 months, due to hemoptysis and sudden death, respectively. The 2 patients who underwent double valve replacement are alive and in good condition afte r a median follow-up of 71 months. Cardiac surgery is indicated in selected patients infected by the human imm unodeficiency virus. These patients are frequently drug abusers or homosexu al. Valvular endocarditis is the most common finding. Hospital morbidity an d mortality rates are higher than usual in this group of patients.