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New World's old disease: cardiac hydatid disease and surgical principles
Omer Tanyeli1, Yuksel Dereli1, Ilker Mercan1
1Department of Cardiovascular Surgery, Meram Medicine Faculty, Necmettin Erbakan University, Konya, Turkey.
Insights
Cardiac hydatid disease, a rare parasitic infection, can be treated effectively with surgery and medication. Early diagnosis and treatment are crucial, especially in endemic areas, to prevent recurrence.
Area of Science:
- Parasitology
- Cardiology
- Infectious Diseases
Background:
- Hydatid cyst disease is caused by Echinococcus granulosus larva.
- It is a significant public health issue in endemic regions.
- Cardiac involvement is an uncommon manifestation.
Purpose of the Study:
- To analyze the clinical characteristics, treatment, and outcomes of cardiac hydatid disease.
- To highlight the importance of considering this rare condition in differential diagnoses.
Main Methods:
- Retrospective review of 12 patients diagnosed with cardiac hydatid disease between 1985 and 2015.
- Surgical interventions included median sternotomy and left anterolateral thoracotomy.
- Medical therapy with mebendazole or albendazole was administered post-surgery.
Main Results:
- The most frequent cyst location was the left side of the heart (50%).
- No surgical mortality was observed.
- All patients received six months of medical therapy with no reported recurrences.
Conclusions:
- Cardiac hydatid disease, though rare, may be increasing in prevalence.
- It should be considered in patients with cardiac symptoms suggestive of mass lesions, particularly in developing countries.
- Surgical cyst removal combined with medical therapy is the definitive treatment.
Background:
Hydatid cyst is a parasitic disease caused by infection with the Echinococcus granulosus tapeworm larva. It is a major public health problem in endemic regions. Cardiac involvement of the disease is rare.
Methods:
Between 1985 and 2015, 12 patients were admitted to our clinic with a possible diagnosis of cardiac hydatid disease. Of these patients, six (50%) were male and six (50%) were female. Mean age of the patients was 42.6 years.
Results:
The most common location of cardiac hydatid disease was left sided (six patients, 50%). Five (41.7%) patients had cysts located in the right heart, whereas one (8.3%) had a cyst in the interventricular septum. Eleven (91.7%) of the patients were operated on via median sternotomy and the remaining one was operated on via a left anterolateral thoracotomy. Ten (83.3%) of the patients were operated on using cardiopulmonary bypass under moderate hypothermia, whereas the remaining two (16.7%) had off-pump surgery. There was no surgical mortality in our series. All patients were discharged with medical therapy (mebendazole or albendazole) for the duration of six months. No recurrences were observed in their follow ups.
Conclusion:
Although cardiac hydatid disease is rare, its prevalence seems to have increased in the last decade. Any patient with suspected cardiac symptoms suggesting mass lesions should be considered for a differential diagnosis of cardiac hydatid disease, especially in developing countries. Definitive treatment is removal of the cyst, combined with medical therapy.
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