A clinical dilemma: cardiac and pericardiac echinococcosis.
BACKGROUND
Cardiac and pericardial echinococcosis as a life-threatening disease may present with a clear picture most of the time, however it may also become a clinical puzzle.


METHODS
In the period between 1977 and 1998, 14 patients were operated on with the diagnosis of cardiac and pericardial echinococcosis. Nine patients were operated on with standard cardiopulmonary bypass (CPB) techniques, and the remaining 5 patients were operated on without CPB. Transesophageal echocardiography (TEE) or intraoperative surface echocardiography were used to plan and perform the operation for the late cases.


RESULTS
One patient died during the postoperative period due to the rupture of interventricular septum. All other patients survived the perioperative period, received mebendazole treatment, and exhibited no recurrence during the follow-up.


CONCLUSIONS
The definitive treatment is the surgical extraction of the cyst. Because the clinical picture may vary according to the number, size, and location of cysts, as well as complications, cardiac echinococcosis should be remembered and included in the differential diagnosis to achieve the treatment. Intraoperative surface echocardiography is of paramount value for diagnosis and planning the management of a successful surgery.
Birincioğlu
C L
CL
Department of Cardiovascular Surgery, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey. b_levent@hotmail.com
Bardakci
H
H
Küçüker
S A
SA
Ulus
A T
AT
Arda
K
K
Yamak
B
B
Taşdemir
O
O
D000293:Adolescent; D000328:Adult; D000969:Antinematodal Agents / Q000008:administration & dosage; D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000601:surgery*; D002315:Cardiopulmonary Bypass; D002648:Child; D003937:Diagnosis, Differential; D004443:Echinococcosis / Q000000981:diagnostic imaging / Q000601:surgery*; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008297:Male; D008463:Mebendazole / Q000008:administration & dosage; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D010496:Pericardium / Q000000981:diagnostic imaging / Q000601:surgery; D011182:Postoperative Care
D000969:Antinematodal Agents; D008463:Mebendazole