Off-Pump Resection of Giant Intramural Left Ventricular Hydatid Cyst by Pleuropericardial Approach: a Case Report
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Dhiren Shah1, Kishore Gupta1, Dhaval Naik1
1Department of Cardiac Surgery, Care Institute of Medical Sciences (CIMS Hospital), Ahmedabad, Gujarat, India.
Insights
Primary cardiac hydatid cyst, a rare condition, can be surgically managed. This case report details a successful off-pump technique for a left ventricular hydatid cyst, minimizing risks.
Area of Science:
- Cardiology
- Parasitology
- Surgical Pathology
Background:
- Primary cardiac hydatid cyst is a rare and potentially fatal cardiac pathology.
- Involvement of the left ventricular free wall presents unique surgical challenges.
Observation:
- A 44-year-old male presented with a large intramural left ventricular hydatid cyst.
- The cyst had a minimum wall thickness of 6 mm.
Findings:
- A successful surgical intervention was performed using a pleuropericardial approach.
- The off-pump technique facilitated direct cyst entry, mitigating mechanical injury risks.
Implications:
- Detailed evaluation enables effective surgical management of cardiac hydatidosis.
- Off-pump surgery reduces risks associated with cardiopulmonary bypass and anaphylaxis.
Abstract:
Primary cardiac hydatid cyst is a rare and fatal pathology, especially when involving the left ventricular free wall. A 44-year-old male was diagnosed with large intramural left ventricular hydatid cyst with wall thickness of 6 mm at the thinnest point. Cyst was accessed through pleuropericardial approach (left pleura opened, followed by entry into cyst directly through adjacent pericardium without removing the pericardial adhesions) which resulted in easy entry into the cyst, mitigating the risk of mechanical injury. This case report highlights that with detailed evaluation, cardiac hydatidosis can be addressed with off-pump technique, reducing the anaphylaxis risks and cardiopulmonary bypass-related effects.
