Background. Cardiac and pericardial echinococcosis as a life-threatening di
sease may present with a clear picture most of the time, however it may als
o become a clinical puzzle.
Methods. In the period between 1977 and 1998, 14 patients were operated on
with the diagnosis of cardiac and pericardial echinococcosis. Nine patients
were operated on with standard cardiopulmonary bypass (CPB) techniques, an
d the remaining 5 patients were operated on without CPB. Transesophageal ec
hocardiography (TEE) or intraoperative surface echocardiography were used t
o plan and perform the operation for the late cases.
Results. One patient died during the postoperative period due to the ruptur
e of interventricular septum. All other patients survived the perioperative
period, received mebendazole treatment, and exhibited no recurrence during
the follow-up.
Conclusions. The definitive treatment is the surgical extraction of the cys
t. Because the clinical picture may vary according to the number, size, and
location of cysts, as well as complications, cardiac echinococcosis should
be remembered and included in the differential diagnosis to achieve the tr
eatment. Intraoperative surface echocardiography is of paramount value for
diagnosis and planning the management of a successful surgery. (C) 1999 by
The Society of Thoracic Surgeons.