Unusual Recurrence of Hydatid Cysts of the Heart: Report of Two Cases and Review of the Clinical and Surgical Aspects of the Disease

Abstract

In cardiac echinococcosis, a hydatid cyst most frequently forms either solely in the heart or in the pericardium, but there are several reports of cysts forming in the liver or lung or in both. In two cases reported here, both patients developed cysts in new sites after one or more previous surgeries for hydatid cyst removal. In Case 1, the patient first underwent spleenectomy and resection of multiple cysts with no evidence of a cyst in the heart; 3 years later, there was no sign of Echinococcus in the liver, but a large inframyocardial cyst had damaged the left ventricle. In Case 2, the patient first underwent surgery to remove cysts from the pericardium, 2 years later from the anterior wall of the left ventricle, and, finally, 8 months after this second operation, from the left atrium also with no evidence of cyst formation anywhere else in the heart at the time of surgery. These cases emphasize the need for thorough and frequent reevaluation to detect new hydatid cyst formation in the heart and elsewhere caused by the Echinococcus organism.

Giant Cardiac Hydatid Cyst in Children: Case Report and Review of the Literature

“…Tufekcioglu et al performed TEE and TTE on all the 16 patients and proposed a scheme for echocardiographic classification of CE lesions based on the World Health Organization (WHO) classification 36,37. To evaluate outflow tract obstruction and the status of coronary arteries, cardiac catheterization and angiography may be useful,38,39 but can cause the rupture of the cyst. Angiography and scintigraphy are useful for pulmonary hydatid embolism diagnosis 39…”

Left Ventricular Epicardial Hydatid Cyst Compressing the Left Circumflex Artery

“…The diagnosis of cardiac hydatid cyst is itself an indication for operation in view of the high risk of catastrophic rupture. Unlike as in other organ involvement, antiechinococcal germicide (Albendazole) should not be given to patients with cardiac hydatid before operative treatment because it may provoke rupture 10 . The first successful operation on heart echinococcosis was performed by Marten and De Crespign in 1921 and the first manipulation under cardiopulmonary bypass by Artucio in 1962 9 .…”

Usefulness of bubble study in echocardiographic diagnosis of contained rupture of hydatid cyst in the right ventricular outflow tract

“…Symptoms from cyst rupture/migration/embolism Anaphylactic reactions 19 Intracardiac migration of cysts (heterotopic cardiac HC disease), 19 Secondary growth in neighboring myocardium Pericardial rupture Tamponade 20 Acute pericarditis 12,20 Constrictive pericarditis (if chronic and partial rupture) 21 Right-sided rupture (right-sided cysts more commonly rupture 6,19,22 ) Pulmonary embolism-acute large volume rupture 20,23 Pulmonary hypertension-chronic, smaller volume rupture 21 defined as a rupture of the endocyst (laminated layer) with an intact pericyst. 7 On the other hand, the bubble study in our patient appeared to show an intact inner layer with rupture of the outer layers.…”