Among all cystic echinococcosis cases, only 0.5%-2% exhibit a cardiac
involvement. Only 10% of these become symptomatic. Considering the long time
interval between the start of infestation and symptoms to occur, it is hard to
diagnose cystic echinococcosis. When detected, even if it is asymptomatic,
intramyocardial hydatid cyst requires surgical intervention due to risks of
spontaneous rupture and anaphylaxis. In literature, no case of hydatid cyst
located in the coronary arterial wall has been reported. Twenty-two-year-old
male patient with previous history of pulmonary cystic echinococcosis was
referred to us with typical symptoms of coronary artery disease. Coronary
cineangiography revealed proximal left diagonal artery (LAD) occlusion.
Pre-operative transthoracic echocardiography of the patient planned to undergo
coronary artery bypass grafting unveiled an intracoronary calcified cystic mass.
In operation, the calcified cystic mass with well-defined borders and size of
2x2 cm located within wall of proximal segment of the LAD artery was excised and
double bypass with left internal thoracic artery (LITA) and great saphenous vein
grafts to the LAD and first diagonal arteries, respectively, was done.
Pathological analysis of the mass revealed it to be an inactive calcified
hydatid cyst. Echinococcal IgG-ELISA test was positive. 12-week oral albendazole
treatment (2x400 mg/day) was launched postoperatively and the patient was
discharged on 7
th
postoperative day.