Surgical experience with cardiac echinococcosis.
Cardiac echinococcosis is a rare affliction of the heart encountered in areas where the tapeworm Echinococcus is endemic. During the 15 years to September 2005, 19 consecutive patients (11 female; mean age, 25.6 +/- 12.8 years) with cardiac echinococcosis were operated on at Damascus University. Diagnosis was mainly established by 2D-echocardiography. Twelve patients also had extracardiac hydatidosis. All patients were operated on using cardiopulmonary bypass and cardioplegia. Intact cysts were generally enucleated, ruptured cysts were exteriorized, and interventricular septal cysts were managed by controlled puncture and aspiration. There was no operative mortality. All patients were placed on mebendazole postoperatively for periods appropriate to the extent of their hydatidosis. There were 4 known late deaths due to systemic extension of the disease. Cardiac echinococcus is a serious disease that should be managed surgically without delay. Enucleation of intact cysts under cardiopulmonary bypass and cardiac arrest is our preferred method of excision. Anthelmintic medical treatment is a valuable and necessary adjunct to surgical management.
Kabbani
Sami S
SS
Damascus University Cardiovascular Surgical Center, Mezza Str., PO Box 2837, Damascus, Syria. dam-uncv@net.sy
Ramadan
Ahmed
A
Kabbani
Loay
L
Sandouk
Aref
A
Nabhani
Fawzi
F
Jamil
Hisham
H
D000293:Adolescent; D000328:Adult; D000871:Anthelmintics / Q000627:therapeutic use; D006348:Cardiac Surgical Procedures; D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality / Q000469:parasitology / Q000601:surgery*; D002315:Cardiopulmonary Bypass; D002648:Child; D003131:Combined Modality Therapy; D018450:Disease Progression; D004443:Echinococcosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006324:Heart Arrest, Induced; D006801:Humans; D008297:Male; D008463:Mebendazole / Q000627:therapeutic use; D008875:Middle Aged; D011677:Punctures; D013396:Suction; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography
D000871:Anthelmintics; D008463:Mebendazole