[Death conference: hindsight in heart surgery].

We report eight cases of death or decerebration occurred during major cardiothoracic surgery. The technical aspects that contributed to the failure are analyzed on the basis of the Italian Criminal Code (art. 43). When this type of event occurs, a case review frequently identifies failure to take action or imprudent behavior. The informed consent regulation currently in force may be helpful in identifying and following the most prudent conduct for the patient. The "death conference" should be a formalized and binding instrument for hospital accreditation.