Surgical Treatment of Isolated Cardiac Echinococciasis: Report of Five Cases

Objective: Cardiac echinococcosis is a rare pathology and in about half of cases it is not accompanied by other organs involvement. We report on our experience of surgical treatment of isolated cardiac echinococcosis (ICE). Methods: Among 5 patients with ICE operated in our clinic 1 had pericardial and epicardial involvement, 1 patient had the single cyst in the apicolateral wall of the left ventricle and 3 patients had singular cysts of the interventricular septum. All patients underwent chest X-Ray, transthoracic echocardiography, ultrasound examinations of the internal organs, hemagglutination tests and microbiologic evaluation of operative specimens. Results: Two operations were performed on a beating heart and three - using cardiopulmonary bypass. In cases of intramyocardial localizations the cyst enucleation and closure of residual cavities by plication were performed and in a case of peri- and epicardial involvement the extirpation of cysts and partial pericardiectomy were carried out. All patients postoperatively received therapy with albendazole. No intra- and postoperative complications were observed. Control echocardiography did not reveal any disturbances of myocardial performance. Two years follow-up showed absence of cyst recurrence. Conclusion: The prevailed localization of echinococci cysts in ICE is the myocardium of the LV and IVST, places with the highest myocardial mass and good perfusion. Ideal echinococcectomy is an effective surgical treatment of isolated cardiac echinococciasis