title: Large cardiac hydatid cyst in the interventricular septum.
abstract: Cystic hydatid disease results from infection with the larval or adult form of the Echinococcus granulosus tapeworm. Cardiac involvement is seen in 0.5% to 2% of patients with hydatid disease, and involvement of the interventricular septum is even rarer. Herein, we report our surgical treatment of a large cardiac hydatid cyst in the interventricular septum. A 39-year-old woman presented with dyspnea. Transthoracic echocardiography revealed a large cyst in the apical part of the interventricular septum. Thoracic computed tomography showed a cystic lesion in that site, and magnetic resonance imaging confirmed the presence of a 50 × 55-mm mass. The patient was placed on cardiopulmonary bypass. Hypertonic saline solution-soaked sponges were distributed within the pericardial cavity to prevent local invasion of the parasite intraoperatively. Through an incision parallel to the left anterior descending coronary artery, and without opening adjacent cardiac chambers, we aspirated the entire contents of the cyst, removed its germinative membrane, and washed the cavity with 20% hypertonic saline solution. The patient recovered uneventfully. She had begun taking albendazole 5 days preoperatively, and this therapy was continued for 12 weeks postoperatively. In cases of an interventricular cardiac hydatid cyst, the combination of surgical resection, washout of the remaining cavity with hypertonic saline solution, and albendazole therapy typically yields excellent results.
authors.affiliation: Department of Cardiovascular Surgery, Cerrahpasa School of Medicine, Istanbul, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Ipek
authors.forename: Suat Nail
authors.initials: SN
authors.lastname: Omeroglu
authors.forename: Deniz
authors.initials: D
authors.lastname: Goksedef
authors.forename: Ozan Onur
authors.initials: OO
authors.lastname: Balkanay
authors.forename: Elmas
authors.initials: E
authors.lastname: Kanbur
authors.forename: Ersoy
authors.initials: E
authors.lastname: Engin
authors.forename: Murat
authors.initials: M
authors.lastname: Baskurt
authors.forename: Serdar
authors.initials: S
authors.lastname: Kucukoglu
mesh_terms: D000328:Adult; D015766:Albendazole / Q000627:therapeutic use; D000923:Anticestodal Agents / Q000627:therapeutic use; D002315:Cardiopulmonary Bypass; D004443:Echinococcosis / Q000175:diagnosis / Q000469:parasitology* / Q000628:therapy; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis / Q000469:parasitology* / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D013396:Suction; D007507:Therapeutic Irrigation; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D054088:Ventricular Septum / Q000469:parasitology*
chemical_list: D000923:Anticestodal Agents; D015766:Albendazole