Direct approach to hydatid cyst of the interventricular septum

A 37-year-old woman who had undergone an operation for hydatid cyst of the liver 10 years earlier decided to have a check-up for echinococcosis, because she had not been seen by a clinician for 4 years. The case is of particular interest not only because it enabled a rare preliminary diagnosis of cardiac echinococcosis by simple electrocardiographic analysis, but also because our technique of excision appears to be one never before reported in connection with interventricular hydatid cysts. In such an instance, we recommend a direct approach (if possible) through the interventricular septum without entering the cardiac chambers, in order to avoid dissemination; and we recommend enucleation of the germinative membrane without capitonnage, to avoid impairment of the atrioventricular conduction pathway or of myocardial contraction. In our patient, electrocardiographic findings improved postoperatively at the 1-year follow-up examination.