Bakkali A, Jaabari I, Bouhdadi H, Razine R, Bennani Mechita N, El Harrag J, Belkhadir A, Benlafqih C, Laaroussi M
Service de chirurgie cardiovasculaire « A », hôpital Ibn Sina, faculté de médecine et de pharmacie, université Mohamed V Rabat, Maroc.
Service de chirurgie cardiovasculaire « A », hôpital Ibn Sina, faculté de médecine et de pharmacie, université Mohamed V Rabat, Maroc.
Ann Cardiol Angeiol (Paris). 2018 Apr;67(2):67-73. doi: 10.1016/j.ancard.2017.04.010. Epub 2017 May 27.
Cardiac hydatid cyst is a rare parasitic disease. The purpose of this study was to describe the clinical, pathological features and the outcome of the surgical treatment of cardiac hydatid disease in our unit over a twenty-year period.
Between May 1994 and May 2014, seventeen cases of cardiac hydatid cysts were operated at our unit. Overall, twelve patients were male (mean age 25±13years). All patients were complaining of dyspnea and 71% presented with chest pain. The diagnosis, based on histological examination, was suspected on echocardiography and computed tomography of chest.
Our study revealed five possible locations, which were in decreasing order of frequency: left ventricle, interventricular septum, right ventricle, left atrium and pulmonary artery. The surgical procedure was a controlled puncture and aspiration of the cyst content, with cystectomy (69%), or pericystectomy (31%). The resulting cavity left open in 6 cases (37.5%) or carefully closed in 10 (62.5%). Hospital mortality was 11.8% (n=2). Morbidity was marked by conduction abnormalities (n=2), bleeding and hematoma of the residual cavity that required surgical treatment (n=3). Eleven patients were followed with a mean period of 40.5±19.4 months. At follow-up, neither late deaths nor recurrence have occurred.
Cardiac hydatid cyst is a serious disease whose treatment is surgical. Cystectomy and pericystectomy remain the two surgical techniques able to offer good chance of cure with acceptable morbidity and mortality.
心脏包虫囊肿是一种罕见的寄生虫病。本研究的目的是描述我们科室二十年间心脏包虫病的临床、病理特征及手术治疗结果。
1994年5月至2014年5月,我们科室对17例心脏包虫囊肿进行了手术。总体而言,12例患者为男性(平均年龄25±13岁)。所有患者均有呼吸困难症状,71%伴有胸痛。基于组织学检查的诊断,通过超声心动图和胸部计算机断层扫描怀疑。
我们的研究揭示了五个可能的部位,按频率递减顺序为:左心室、室间隔、右心室、左心房和肺动脉。手术方式为对囊肿内容物进行控制性穿刺抽吸,并行囊肿切除术(69%)或囊肿外膜切除术(31%)。6例(37.5%)的残留腔敞开,10例(62.5%)仔细缝合。医院死亡率为11.8%(n = 2)。并发症以传导异常(n = 2)、残留腔出血和血肿需手术治疗(n = 3)为特征。11例患者接受随访,平均随访时间为40.5±19.4个月。随访期间,未发生晚期死亡和复发。
心脏包虫囊肿是一种严重疾病,其治疗方法为手术治疗。囊肿切除术和囊肿外膜切除术仍然是两种能够提供良好治愈机会且发病率和死亡率可接受的手术技术。