[Mortality and morbidity in HIV-infected patients undergoing coronary artery bypass surgery: a case control study].
The use of highly active antiretroviral therapy (HAART) in patients with HIV infection has improved survival. This improvement combined with the metabolic effects of treatment has increased cardiovascular risk and the need for cardiac surgery in these patients. We compared morbidity and mortality in HIV-infected patients (cases, n=7) and non-HIV-infected patients (controls, n=21) who underwent isolated coronary artery surgery between 1997 and 2004. The durations of extracorporeal circulation and aortic cross-clamping were shorter in HIV-infected patients (P=.002 and P=.014, respectively). The percentage of patients who experienced complications was similar, at 57.1% in both groups, but there was a slightly higher number of complications per patient in non-HIV-infected individuals. The mean length of total hospitalization was greater in HIV-infected patients (27.1 [13.3] versus 8.8 [5.3] days; P=.003), as was that of postoperative hospitalization (18.2 [15.4] vs 7.9 [4.2] days; P=.08). No HIV-infected patient died or needed a repeat cardiac operation. No progression of the HIV infection was observed. Isolated coronary artery surgery in HIV-infected patients produces good results, and there is no increase in morbidity or mortality. Extracorporeal circulation did not influence disease progression.
Jiménez-Expósito
María J
MJ
Servicio de Enfermedades Infecciosas, Hospital Clínic, Universidad de Barcelona, España.
Mestres
Carlos A
CA
Claramonte
Xavier
X
Cartañá
Ramón
R
Josa
Miquel
M
Pomar
José L
JL
Mulet
Jaume
J
Miró
José M
JM
D000328:Adult; D016022:Case-Control Studies; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D003627:Data Interpretation, Statistical; D018450:Disease Progression; D005112:Extracorporeal Circulation; D015658:HIV Infections / Q000150:complications*; D018023:HIV Seronegativity; D006679:HIV Seropositivity; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome