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包虫囊肿的罕见部位:三尖瓣后叶

Unusual location of hydatid cyst: the posterior leaflet of tricuspid valve.

作者信息

Kurdal Adnan Taner, Kahraman Nail, Iskesen Ihsan, Sirin Bekir Hayrettin

机构信息

Department of Cardiovascular Surgery, Celal Bayar Univ. School of Medicine, Manisa, Turkey.

出版信息

Ann Ital Chir. 2010 May-Jun;81(3):211-4.

Abstract

Hydatid Cyst disease involves the heart in 0.02-2% of the cases. It can appear with symptoms very similar to coronary artery disease, cardiac valvular disease and pericarditis. We present a case of hydatid cyst that was located on the posterior tricuspid leaflet and that caused tricuspid regurgitation in 37 year old female patient who has gone through hydatid cyst excision from the bilateral lungs with median sternotomy 2 years ago. In addition to the right atrial and ventricular dilatation, second degree tricuspid regurgitation and significant pulmonary hypertension was found. The 2 x 2 cm smooth surfaced mass was resected from the posterior leaflet of the tricuspid valve and the defect was closed with suture with the aid of cardiopulmonary bypass. The patient followed with long term albendazole treatment. Cardiac echinococcosis should be kept in mind in some patients throughout their life with a history of previous hydatid cyst disease. Surgical excision without rupture is the treatment of choice for cardiac hydatid cyst, with following medical therapy in order to prevent recurrence.

摘要

包虫囊肿病累及心脏的病例占0.02% - 2%。其症状可能与冠状动脉疾病、心脏瓣膜病和心包炎非常相似。我们报告一例位于三尖瓣后叶的包虫囊肿病例,该囊肿导致一名37岁女性患者出现三尖瓣反流,该患者两年前曾通过正中胸骨切开术切除双侧肺部的包虫囊肿。除右心房和心室扩张外,还发现了二度三尖瓣反流和严重肺动脉高压。从三尖瓣后叶切除了一个2×2厘米表面光滑的肿块,并在体外循环辅助下用缝线封闭缺损。患者接受了长期阿苯达唑治疗。对于有既往包虫囊肿病病史的一些患者,应终生牢记心脏棘球蚴病。对于心脏包虫囊肿,无破裂的手术切除是首选治疗方法,术后需进行药物治疗以防止复发。

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