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Hydatid cyst of the heart. Clinical and surgical implications.

Hydatid cyst of the heart is an uncommon lesion which usually develops in the left ventricle. Diagnosis should be considered in patients coming from an area where hydatid cyst is endemic and who present with an abnormal heart shadow on chest X-ray, frequently associated with T wave changes on the electrocardiogram. The cyst tends to grow and thus compress the neighboring myocardium. It causes displacement of the coronary vessels, rhythm disturbances and mechanical interference with the AV valves and ventricular function. Spontaneous involution of the cyst with calcification of its wall as well as rupture with anaphylactic shock may occur. Early excision with standby cardiopulmonary bypass is advisable. Three patients with hydatid cyst of the left ventricle, 2 of whom were operated on by using cardiopulmonary bypass, are presented. Results of the surgical treatment, both early and late, are rewarding, with relief of symptoms, regression of electrocardiographic abnormalities and very low incidence of recurrence.