No abstract

The hydatid disease is one of the most common tapeworm infections. It is caused most commonly by Echinococcus granulosus and has an endemic distribution. The transmission to humans, which are intermediate hosts, occurs by ingestion of contaminated food and water or by direct contact with infected animals. Involvement of heart and pericardium is an extremely rare condition. We present a case of an 18-year-old female patient, admitted in cardiology department complaining of chest pain and subfebrility. Transthoracic echocardiography and contrast enhanced CT revealed huge well-organized intramyocardial cyst in the lateral left ventricular wall with a few daughter cysts. The diagnosis of cardiac echinococcosis was confirmed by serological blood test - ELISA. We performed total resection of the cyst using extracorporeal circulation. The postoperative period was uneventful. Albendazole treatment was administered. The patient was followed-up one year with good postoperative result without any signs of relapse of the disease. Cardiac hydatid disease is rarity, but it is a life-threatening condition because of the high risk of cyst perforation. Early diagnosis and treatment are crucial. Echocardiographic findings are extremely valuable for diagnosis. The results of surgical echinococcectomy combined with oral antihelmintic therapy postoperatively are preferred rather than conservative strategy alone.

Takotsubo cardiomyopathy is a syndrome characterized by transient acute left ventricular dysfunction, electrocardiographic changes that can mimic acute myocardial infarction and minimal release of myocardial enzymes in the absence of obstructive coronary artery disease (CAD). Reports of Takotsubo syndrome after cardiac surgery are exceptional. We describe a case of Takotsubo cardiomyopathy in a 57-year-old man after elective aortic and mitral valve replacement following recent convalescence from infective endocarditis. Takotsubo syndrome should be considered in the differential diagnosis of patients presenting acute myocardial infarction, cardiogenic shock or any low cardiac output syndrome after cardiac surgery.

We present the case of a 44-year-old gentleman, hospitalized in Interventional cardiology department with retrosternal pain. Percutaneous coronary investigation(PCI) was performed demonstrating bilateral ostial coronary artery stenosis with moderate aortic regurgitation. The patient was transferred in our department for urgent surgery. Cardiac surgery procedure was performed including: double coronary artery bypass grafting (CABG) combined with aortic valve replacement(AVR) with mechanical valve. The Venereal Disease Research Laboratory test (VDRL) and Treponema pallidum Haemagglutination(TPHA) test were done on admission – both of them being positive. Those results confirmed tertiary cardiovascular syphilis. The patient was discharged on POD 12, and was transferred to Dermatology and sexually transmitted diseases(STD) department for further antibiotic therapy concerning the syphilis infection.

In the following article we present a case of postoperative chylothorax as rare and severe complication after cardiac surgery. We present a case of 56-year-old man after double-valve replacement procedure and aorto-coronary artery bypass grafting, including pedicled left internal mammary artery towards left anterior descending artery. By the tenth postoperative day the total amount of drained milky white fluid from the left pleural cavity reached the colossal volume of 13 040 ml, despite the conservative therapy with intravenous Sandostatin (Octreotide) and parenteral feeding with a solution rich in medium chain triglycerides and amino acids – OliClínomel. The results of the biochemical analysis confirmed the diagnosis chylothorax. On the tenth postoperative day, a revision of the left pleural cavity through left thoracotomy was performed and lesion of the thoracic duct was identified. The lesion was sutured and secured with fibrin tissue glue – Tissucol for definitive treatment of the lymphorrhagia. The combined therapeutic and surgical approach concerning this serious complication turned out to be effective, and the patient was discharged on the thirty-second postoperative day with significant clinical improvement without ultra-sound and x-ray data for left pleural effusion.