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Published on: July 18, 2014
Three cases of cardiac hydatidosis: diagnosis, surgical treatment, and complications
1Departments of General Surgery 1st di Clinica Chirurgica, University of Sassari, Italy.
Insights
Cardiac hydatid disease is rare but serious. Early diagnosis via echocardiography is crucial for treating Echinococcus granulosus cysts in the heart to prevent complications like embolism.
Area of Science:
- Cardiology
- Parasitology
- Infectious Diseases
Background:
- Hydatidosis, caused by Echinococcus granulosus, commonly affects various organs.
- Cardiac involvement is a rare but severe manifestation of hydatid disease.
Observation:
- Reported are three cases of cardiac hydatid disease.
- Cyst locations and resulting complications varied, including pulmonary and peripheral embolism.
- One case was diagnosed incidentally without complications.
Findings:
- Rupture of cardiac hydatid cysts can lead to life-threatening embolism.
- Surgical intervention (pericystectomy) with cardiopulmonary bypass was performed in two cases.
- Outcomes varied, with the unruptured case faring best; one patient developed hemiparesis.
Implications:
- Early diagnosis and prompt treatment are vital for managing cardiac hydatidosis.
- Echocardiography is recommended for cardiac symptoms in endemic regions.
- Pericystectomy for cardiac hydatid disease carries a high mortality risk, underscoring the need for cautious management.
Abstract:
Three cases of cardiac hydatid disease from among the many cases of hydatidosis (>300) in various organs observed by the authors are reported. The sites of the cysts and the complications that arose are described. The first case developed hydatid pulmonary embolism caused by rupture into the right ventricular cavity, the second suffered peripheral hydatid embolism caused by rupture into the left ventricular cavity, and the third, whose diagnosis was fortuitous, had no complications. The first patient died shortly after admission. The other two underwent radical pericystectomy and partial pericystectomy with cardiopulmonary bypass. The best result was obtained in the third case where rupture had not occurred. The second patient recovered but developed hemiparesis. The various diagnostic tools available are discussed, as well as some technical aspects of pericystectomy, which has a high mortality rate. The importance of early diagnosis and treatment of this rare localization of Echinococcus granulosus is emphasized, and echocardiography is recommended even for nonspecific cardiac symptoms in areas where the parasite is endemic.
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