Heart echinococcosis: current problems and surgical treatment

Abstract

We present some historical, epidemiological, statistical data for heart echinococcosis and concomitant lesions of different organs. The diagnosis of heart echinococcosis is based on revealing of the cyst and its identification with echinococcus. The value of different diagnostic methods is shown. A surgical procedure in patients with heart echinococcosis depends on the localization of the cysts (manipulations under cardiopulmonary bypass or off-pump procedure). We present some additional techniques for prophylaxis of recurrence.

Diagnosis and treatment of cardiac echinococcosis

“…Alternatively, it seems imaginable to remove especially superficially located and palpable hydatid cysts on the beating heart 37 40–43. For the detection of profound myocardial cysts, intraoperative surface sonography can be used, since a palpation for localisation and size estimation of those cyst(s) is insufficient 41 43. To prevent intraoperative spreading, palpation and surface ultrasound should be done with extreme care and the pericardium should be tamponaded with abdominal swabs to minimise spreading of the cyst content into the pericardial sac or the mediastinum.…”

Fatal pulmonary embolism in an adolescent case: Cardiac and hepatic hydatic cyst

“…Cardiac involvement is a very rare involvement, and the left ventricle (60 to 70%) is the most frequently affected region. [5] Decreasing order of frequency is right ventricle (10%), pericardium (7%), pulmonary artery (6%), atrial appendix (6%), and interventricular septum (4%). [6,7] Pulmonary artery localization is a rare form of hydatid cysts.…”

“…Occasionally, patients are lost secondary to anaphylactic shock, cardiac tamponade, and systemic or pulmonary embolization. The most life-threatening complication of cardiac hydatid cyst is perforation and with a reported intra-cardiac perforation frequency of 25 to 40%, [6][7][8][9][10] After cyst perforation, three quarters of the patients die from embolic complications.…”

Surgical treatment of an Echinococcus cyst of the interventricular septum complicated by septic endocarditis, complete atrioventricular block, and rupture into the Valsalva sinus

“…Identifi cation is based on serological reactions, ultrasonography (US), radiography, computed tomography (CT), and magnetic resonance imaging (MRI). 8 The sensitivity of the serological reactions is not high, and parameters frequently do not correspond to the changes. 9 For the indirect hemagglutination analysis, a false-negative reaction was seen in 25% and a doubtful reaction in 5%.…”

“…For the immunoenzymatic analysis, a false-negative reactions was seen in 25% and a doubtful reaction in 5.7%. 8 Echocardiography is a simple, reliable method for diagnosing echinococcosis. 10 In cases of echinococcosis in the heart, pericystectomy is rarely undertaken owing to concern about removing a myocardial mass, hemorrhage, and damage to the heart structures.…”