Introduction Pericardial hydatid cyst comprises 7% of all cardiac hydatidosis, but its occurrence is concomitant with several life-threatening complications. This study is a review of the reported studies of pericardial hydatid cysts. Methods A systematic review of the published studies of pericardial hydatid cysts was conducted. The studies of cardiac hydatid cysts with the following properties were included: 1) The pericardium infection was confirmed by diagnostic modalities, surgical findings, or histopathology. 2) The case presentation was provided in the study. 3) The cyst (s) originally located or adhered to the pericardium and did not rupture into it from the other adjacent cardiac structures or organs. Results Overall, 106 studies were compatible with the inclusion criteria. Most of the cases (29.72%) were reported in Turkey, followed by India (18.24%). There was no gender predilection, and the age of the patients was distributed between 5 and 80 years old. The most common symptoms were chest pain (43%), and dyspnea (36%). Hydatid cysts were only found in the pericardium in 56% of cases and multiloculated in 44%. Surgery was the treatment of choice (87.8%), and cystectomy (72.3%) was the major technique of cyst removal. The total number of recurrences was 3 cases (2%). There was a significant correlation between recurrence and the history of hydatidosis. The mortality rate was 2.7%. Conclusion Pericardial hydatid disease is more common in subtropical regions. The definitive treatment of a pericardial hydatid cyst is surgery, mainly through a median sternotomy. A history of hydatidosis increases the likelihood of recurrence.
BackgroundCardiac myxoma is a rare cardiac tumor that may be asymptomatic or can cause embolization or intracardiac obstruction, leading to heart failure, sudden cardiac death, and arrhythmia. This study aims to report an 11-year experience of a single center in the management of cardiac myxoma.MethodThis study is a single-center retrospective case series. Eighty cases of cardiac myxoma were collected in Ibn Albitar's specialized center for cardiac surgery. Transthoracic echocardiography was used to make the preoperative diagnosis in all patients. The surgeries were undertaken through the standard approach of a median sternotomy. All four cardiac chambers were thoroughly explored for additional myxomas. The major objective of the operations was complete tumor resection.ResultThe mean age of the patients was 46.3 years. Females (67.5%) were predominant over males (32.5%). Shortness of breath was the most common symptom (86.25%). The left atrium was the most affected site (83.75%), followed by the right atrium (13.75%). Coronary artery bypass grafting was required as the secondary or associated intervention in 19 (23.75%) cases. The recurrence rate was 11.25%, with a mortality rate of 3.75%.ConclusionRecurrence and tumor embolism are risks of surgical intervention for myxoma. Good preparation using transthoracic echocardiography as a diagnostic tool and standard median sternotomy to complete resection of the tumors can decrease the rate of recurrence, embolism, and even mortality.
the Bentall procedure is a surgical technique used in the management of aortic root abnormalities with ascending aorta and aortic valve issues. the present study aimed to evaluate the outcomes of 18 patients treated with the Bentall procedure in a single center. the present study was a single-center retrospective case series conducted over a period of 3 years. the patients had either acute ascending dissection and/or dilated ascending aorta with aortic valve dysfunction. the Bentall procedure was performed via standard median sternotomy. St. Jude Medical composite grafts with a valve were applied in all cases. a total number of 18 patients with either acute ascending dissection and/or dilated ascending aorta with aortic valve dysfunction were included in the study. the age of the participants ranged from 27-60 years. the ratio of males to females was 16:2 (males, 88.8%). the symptoms developed 3-4 days prior to hospital admission. Chest pain was the most common presenting symptom (n=10, 55.5%). Hypertension was the most common risk factor (n=12, 66.6%). In total, 14 cases underwent emergency surgery (77.7%). the emergency surgery was performed in 9 patients within 24 h of arrival owing to the association of aortic root dissection with tamponade. For the other cases, the surgery was performed within 2 and 7 days (n=5, 27.7% and n=4, 22.2%) respectively. Early post-operative complications occurred in 5 patients (27.7%). on the whole, as demonstrated herein, the modifications of the Bentall procedure have a notable impact on decreasing the overall mortality rates. raising the awareness of clinicians and the general population as regards aortic dissection may aid in the early referral of patients to specialized centers and may thus decrease the overall mortality rate.
Pseudo-Wellens syndrome refers to any electrocardiogram (ECG) pattern that mimics Wellens syndrome with no critical left anterior descending (laD) artery-associated coronary artery disease. the present study describes a rare case of pseudo-Wellens syndrome associated with pulmonary embolism. a female patient presented with chest tightness for 72 h. the precordial examination and heart sounds were normal. a mild bilateral lower pitting leg edema with a superficial varicose vein was observed. The levels of C-reactive protein (98.80 mg/l) and D-dimer (7599.9 ng/ml) were abnormal. An electrocardiogram presented a biphasic inversion of the T-wave in precordial leads in the pain-free interval. Coronary angiography did not reveal any notable findings. A computed tomography pulmonary angiography demonstrated an acute pulmonary embolism. The patient received unfractionated heparin (20,000 IU) by intravenous infusion. She was discharged on rivaroxaban (15 mg) twice daily for 21 days. The inverted T-wave specificity, sensitivity and positive predictive values for LAD stenosis are 89, 69 and 86% respectively. This indicates that ECG alternations with the properties of Wellens syndrome do not always guarantee its occurrence, and in the presence of a normal coronary artery, the condition may be pseudo-Wellens syndrome. the case described herein suggests that clinicians need to carefully screen patients that have pulmonary embolisms with an abnormal electrocardiographic pattern in order to prevent unnecessary intervention.
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