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Case Reports
. 2011;38(6):719-22.

Large cardiac hydatid cyst in the interventricular septum

Gokhan Ipek  1 , Suat Nail Omeroglu, Deniz Goksedef, Ozan Onur Balkanay, Elmas Kanbur, Ersoy Engin, Murat Baskurt, Serdar Kucukoglu
Affiliations
Case Reports

Large cardiac hydatid cyst in the interventricular septum

Gokhan Ipek et al. Tex Heart Inst J. 2011.

Abstract

Cystic hydatid disease results from infection with the larval or adult form of the Echinococcus granulosus tapeworm. Cardiac involvement is seen in 0.5% to 2% of patients with hydatid disease, and involvement of the interventricular septum is even rarer. Herein, we report our surgical treatment of a large cardiac hydatid cyst in the interventricular septum. A 39-year-old woman presented with dyspnea. Transthoracic echocardiography revealed a large cyst in the apical part of the interventricular septum. Thoracic computed tomography showed a cystic lesion in that site, and magnetic resonance imaging confirmed the presence of a 50 × 55-mm mass. The patient was placed on cardiopulmonary bypass. Hypertonic saline solution-soaked sponges were distributed within the pericardial cavity to prevent local invasion of the parasite intraoperatively. Through an incision parallel to the left anterior descending coronary artery, and without opening adjacent cardiac chambers, we aspirated the entire contents of the cyst, removed its germinative membrane, and washed the cavity with 20% hypertonic saline solution. The patient recovered uneventfully. She had begun taking albendazole 5 days preoperatively, and this therapy was continued for 12 weeks postoperatively. In cases of an interventricular cardiac hydatid cyst, the combination of surgical resection, washout of the remaining cavity with hypertonic saline solution, and albendazole therapy typically yields excellent results.

Keywords: Albendazole/therapeutic use; Turkey; cardiac surgical procedures/methods; cardiomyopathies/parasitology; echinococcosis/diagnosis/pathology/surgery; heart diseases/parasitology; treatment outcome; ventricular septum/parasitology/surgery.

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Figures

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Fig. 1 Computed tomograms taken at the A) T8 and B) T9 levels show the hydatid cyst (arrows).
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Fig. 2 Magnetic resonance images of the hydatid cyst (arrows) in A) sagittal and B) axial views.
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Fig. 3 Diagram depicts the incision (broken line) parallel to the left anterior descending coronary artery on the right side.
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Fig. 4 Intraoperative photographs show A) an external view and B) the cavity of the hydatid cyst.
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Fig. 5 Photograph shows the germinative membrane of the cyst that was removed from the interventricular septum.
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Fig. 6 Diagrams depict capitonnage and closure of the incision with the use of Teflon felt.
See this image and copyright information in PMC

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