Cardiac and pericardial hydatid cysts: a single center analysis of 22 cases


Usta H., Colak A., Aydin Y., Kaya U., Kocak H., Ceviz M., ...Daha Fazla

BMC CARDIOVASCULAR DISORDERS, cilt.25, sa.1, 2025 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 25 Sayı: 1
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1186/s12872-025-05366-4
  • Dergi Adı: BMC CARDIOVASCULAR DISORDERS
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, Directory of Open Access Journals
  • Atatürk Üniversitesi Adresli: Evet

Özet

ObjectivesCardiac and pericardial hydatid cysts are rare, with cardiac involvement observed in only 0.02-2% of all cases in the body. In this study, we evaluated the clinical characteristics, anatomical distribution, and treatment strategies of cardiac and pericardial hydatid cyst cases treated in our clinic. Additionally, a comprehensive review of the literature was conducted.MethodsIn this single-center retrospective study, the outcomes of 22 consecutive cases with cardiac and pericardial hydatid cysts were analyzed between January 2008 and May 2023. Patients were followed for an average of 5.3 years from the time of diagnosis.ResultsOf the 22 cases, 10 were male (45.4%) and 12 were female (54.6%), with a mean age of 31.9 +/- 20.3 years (range: 7-79 years). The most common presenting symptoms were chest pain (50.0%), dyspnea (22.7%), and cough (18.2%). Cardiac involvement was present in 18 patients (81.8%) and pericardial involvement in 4 patients (18.2%). Among the 18 patients with cardiac hydatid cysts, 8 had involvement of the left ventricle, 5 of the right ventricle, and 5 of the interventricular septum. Isolated cardiac involvement was observed in 8 patients (36.6%), while in 14 patients (63.4%) hydatid cysts were also present in other organs. Pulmonary involvement was found in 9 patients (40.9%), hepatic in 8 (36.4%), splenic in 2 (9.1%), diaphragmatic in 2 (9.1%), and single cases of cerebral, renal, chest wall, and psoas muscle involvement were also identified.Surgical treatment was performed in 20 patients (90.9%), while 2 patients (9.1%) received only medical therapy due to refusal of surgery. Among the surgically treated patients, 17 (85.0%) underwent median sternotomy, and 3 (15.0%) were treated via left anterior thoracotomy. No recurrence of cardiac or pericardial hydatid cysts was observed in any of the surgically treated cases. There was no surgery-related mortality. However, both patients who received only medical treatment died due to cyst-related complications during their one- and two-year follow-up respectively.ResultsOf the 22 cases, 10 were male (45.4%) and 12 were female (54.6%), with a mean age of 31.9 +/- 20.3 years (range: 7-79 years). The most common presenting symptoms were chest pain (50.0%), dyspnea (22.7%), and cough (18.2%). Cardiac involvement was present in 18 patients (81.8%) and pericardial involvement in 4 patients (18.2%). Among the 18 patients with cardiac hydatid cysts, 8 had involvement of the left ventricle, 5 of the right ventricle, and 5 of the interventricular septum. Isolated cardiac involvement was observed in 8 patients (36.6%), while in 14 patients (63.4%) hydatid cysts were also present in other organs. Pulmonary involvement was found in 9 patients (40.9%), hepatic in 8 (36.4%), splenic in 2 (9.1%), diaphragmatic in 2 (9.1%), and single cases of cerebral, renal, chest wall, and psoas muscle involvement were also identified.Surgical treatment was performed in 20 patients (90.9%), while 2 patients (9.1%) received only medical therapy due to refusal of surgery. Among the surgically treated patients, 17 (85.0%) underwent median sternotomy, and 3 (15.0%) were treated via left anterior thoracotomy. No recurrence of cardiac or pericardial hydatid cysts was observed in any of the surgically treated cases. There was no surgery-related mortality. However, both patients who received only medical treatment died due to cyst-related complications during their one- and two-year follow-up respectively. ConclusionsCardiac involvement of hydatid cysts is a life-threatening condition that requires prompt surgical intervention. Postoperative albendazole therapy should be administered to prevent recurrence. In patients who refuse surgery, medical therapy may offer limited prolongation of survival.