Surgical treatment of cardiac hydatid disease in 13 patients

Cardiac hydatidosis is an uncommon but potentially fatal disease. It remains endemic in developed and developing countries. Its clinical presentation ranges from an absence of symptoms to congestive heart failure or other life-threatening sequelae. Herein, we report our clinical experience with the disease. From 1991 through 2009, 7 male and 6 female patients (mean age, 36 +/- 18.3 yr; age range, 10-68 yr) underwent surgical treatment at our hospital for cardiac hydatid disease. Cardiac hydatidosis was established as a component of multiorgan echinococcosis in 8 patients, and it was diagnosed upon echocardiographic examination in the other 5 during investigation of their nonspecific symptoms. Hydatid cysts were found in the left ventricle (in 5 patients); the right ventricle (in 3); the interventricular septum (in 2); and the interatrial septum, right atrium, and left atrium (in 1 each). All 13 patients underwent sternotomy and surgery under cardiopulmonary bypass. No intraoperative rupture or operative death occurred. The only sequela was complete atrioventricular block that necessitated pacemaker implantation in a patient whose hydatid cyst had involved the basal interventricular septum. All patients underwent subsequent treatment with albendazole (400 mg/d). One patient experienced a recurrence 1 year postoperatively. We discuss our surgical approaches, the outcomes in our patients, and diagnostic and therapeutic recommendations.