Results
Data available to date show no conclusive evidence of acceleration of HIV infection into AIDS associated with cardiac surgery [5]. Five of 25 investigators (20%) saw HIV infection progress to AIDS within a maximum period of 74 months [5].
In a short report of six patients, Lemma et al. [46] could not demonstrate any deleterious effect of ECC in HIV-infected patients. Preoperative and postoperative absolute lymphocyte T-helper (CD4) and T-suppressor (CD8) counts did not show a close association between the temporary lymphopenia induced by cardiopulmonary bypass and progression to AIDS [48]. The fear that cardiopulmonary bypass might cause acceleration of the disease has not been borne out [3].Cardiac surgery in HIV-infected patients is complicated by higher mortality and morbidity rates than in other patients (20% hospital death for Aris et al. [20] with the majority occurring in valvular surgery [27]), but this fact has tended to decrease substantially (2.7% of hospital death for Trachi- otis et al. [7] with the majority involving a CABG). This group of high-risk patients has the following characteristics: immunodepression, poor general condition, associated diseases, infections, intravenous drug abuse, homosexual/bisexual behavior, high rate of infectious valve endocarditis, frequent recurrence of postoperative infection, and increased risk of transmission to clinical staff. The long-term survival is difficult to describe because there is still a high mortality in patients operated on for severe endocarditis; however, the mid-term results of CABG are unremarkable.