**5. Innovation and research, conflict of interests**

Scientific research is an essential part of a heart surgeon's activity. Research must be understood as a systematic investigation aimed at a reflection, followed by scientific evaluation and analysis of the results. The scientific research results are the final product of the work and the correct analysis of the collected data. The faithful exposure of the latter is necessary to respond "ethically" to the need for health [11].

An ethical violation in the field of scientific research is present in case of falsification/fabrication of the results (failure to publish complications related to the intervention, operative mortality, causes of death during a clinical follow-up), or when it is present excessive influence of industry. In randomized clinical trials, in which patients are generally divided into two or more groups to receive a different treatment, absolute impartiality of judgment (not influenced by industry, personal interests) is required to analyze the results. For this reason, many of the studies are conducted in a "double-blind" manner, in which neither the doctor nor the patient is aware of the type of treatment received. Conflict of interest occurs when there are divergences between individual interests and the surgeon's profession's obligations [12]. Conflict of interest can arise due to problems related to the relationship between surgeon and patient and between surgeon and industry, or finally, between public and private activities. Conflict of interest is frequent and even wholly unavoidable. Therefore, the moral purpose is not to cancel it altogether - it would be impossible - but to manage it, always managing to guarantee the prevalence of the primary interest (the patient's health) over secondary interests (e.g., personal earnings and gratification, remuneration). The conflict of interest that may occur between surgeon and industry may be, for example, the choice of a prosthesis that does not give the same guarantees as other more tested prostheses (in this case, personal interest prevails).
