Hydatid Cyst in the Wall of the Ascending Aorta

Abstract

Hydatid disease rarely involves the aortic wall. We report a case of hydatidosis involving the ascending aorta and the left atrium. The patient underwent replacement of the ascending aorta with a prosthetic Dacron graft and left atrial cystectomy. At the 6-month follow-up, she was leading a normal life.

Hydatid cyst involving the aortic arch

“…Rarely, it can reach to systemic circulation and may infest any organ. The hydatid disease may cause life threatening complications such as anaphylactic shock, hemorrhage, systemic emboli, and arterial occlusion [1][2][3]7]. This case is an example of its malignant behavior.…”

“…By the use of partial resection and patch repair, good outcome in a descending aortic [5], recurrent fatal bleeding in one [2], and false aneurysm in another case [6] of abdominal aortic hydatidosis were reported. However, resection with graft interposition has been successful in all reported cases [1,7]. In addition to graft interposition, we removed all the pericystic adventitia in order not to leave a cavity behind due to its potential risk for perigraft infection.…”

“…Aortic wall involvement by the hydatid cysts are very rare, and less than 20 cases have been reported, all but 1 being the descending thoracic or abdominal aorta [1][2][3][4][5][6]. A case of hydatid cyst involving the ascending aorta and the left atrium was reported [7]. We report a case of hydatidosis involving the proximal aortic arch.…”

Massive haemoptysis due to aortobronchial fistula caused by pulmonary hydatidosis

“…Hydatid disease is caused by the intestinal parasitic tapeworm E. granulosus which, in Australia, is most prevalent in the eastern half of NSW at higher altitudes 1 . Symptomatic intramural aortic‐wall hydatidosis causing aortic‐wall rupture and pseudoaneurysm formation has been described in fewer than a dozen cases 2 …”

“…Hypotheses for arterial‐wall invasion include dissemination during cardiac surgery; entry through vasa vasorum or pre‐existing small intimal tears or aneurysms; or partial incorporation of the aortic wall into the hydatid pericyst 2 , 3…”