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Synchronized coronary revascularization and multiple cardiac cysthydatid operation
Levent Yilik1, Kazim Ergüneş, Ufuk Yetkin
1Izmir Ataturk Education and Research Hospital, Department of Cardiovascular Surgery, Izmir, Turkey.
Heart & Lung : the Journal of Critical Care
|February 26, 2004
Summary
This case report details a rare cardiac cysthydatid in a 61-year-old man, successfully treated with synchronized surgery for both the parasitic cysts and coronary artery disease. Early diagnosis and surgical intervention are crucial for managing this potentially lethal condition.
Area of Science:
- Cardiology
- Parasitology
- Surgical Pathology
Background:
- Cardiac cysthydatid, a rare manifestation of echinococcal infection (0.5-2%), often involves the ventricles.
- Presentation can range from asymptomatic to severe symptoms like fever, dyspnea, and chest pain.
Observation:
- A 61-year-old male presented with symptoms suggestive of cardiac compromise and was diagnosed with a ruptured cysthydatid in the right atrium and multiple cysts on the left ventricle apex.
- Echocardiography identified a cystic mass in the right atrium, while coronary angiography revealed severe stenosis in the left anterior descending artery.
- Preoperative serology for cysthydatid was negative, highlighting the limitations of serological testing.
Findings:
- A synchronized surgical approach was employed, involving resection of the ruptured right atrial cyst and excision of previously undiagnosed left ventricular apex cysts.
- Coronary artery bypass grafting using the left internal mammary artery was performed concurrently.
- Histopathology confirmed the diagnosis of cardiac cysthydatid.
Implications:
- This case underscores the importance of considering cardiac cysthydatid in endemic areas, even with negative serology.
- Synchronized surgical management of cardiac cysthydatid and concurrent coronary artery disease is feasible and effective.
- Prompt diagnosis and surgical intervention are vital for preventing potentially fatal outcomes associated with cardiac cysthydatid.