Unusual recurrence of hydatid cysts of the heart: Report of two cases and review of the clinical and surgical aspects of the disease

In cardiac echinococcosis, a hydatid cyst most frequently forms either sole ly in the heart or in the pericardium, but there are several reports of cys ts forming in the liver or lung or in both. In two cases reported here, bot h patients developed cysts in new sites after one or more previous surgerie s for hydatid cyst removal. In Case 1, the patient first underwent spleenec tomy and resection of multiple cysts with no evidence of a cyst in the hear t; 3 years later, there was no sign of Echinococcus in the liver, but a lar ge inframyocardial cyst had damaged the left ventricle. In Case 2, the pati ent first underwent surgery to remove cysts from the pericardium, 2 years l ater from the anterior wall of the left ventricle, and, finally, 8 months a fter this second operation, from the left atrium also with no evidence of c yst formation anywhere else in the heart at the time of surgery. These case s emphasize the need for thorough and frequent reevaluation to detect new h ydatid cyst formation in the heart and elsewhere caused by the Echinococcus organism.