Cardiac echinococcosis

Cardiac echinococcosis is an extremely rare disease, seen worldwide. Some clinical characteristics are unknown, and treatment modalities are unclear.

41 patients diagnosed with cardiac or pericardial echinococcosis underwent surgery. We evaluated the patients echocardiographically in 8 different categories: cardiac echinococcosis lesions located within the heart, imaging appearance of each lesion, activity of the cysts, mode of cardiac echinococcosis, and number of cardiac lesions per patient. The surgical technique was reevaluated according to the intraoperative echocardiographic findings, especially according to the mode of the lesion.

The hydatid cysts were located in the ventricular wall in 34 cases, the right atrium in 2, the noncoronary sinus Valsalva of the aorta in 1, between the aorta and the pulmonary bifurcation in 1, and in the pericardium alone in 4 cases. In 1 case, septal rupture occurred and the patient died. Relapse was seen in 1 patient who was operated on due to multiple ventricular and pericardial cysts; this patient underwent a second operation 6 years and 8 months after the initial surgery.

Recent echocardiographic developments and application of intraoperative echocardiography enables a detailed classification for extirpation, and allows successful treatment.