Wadhawa Vivek, Shah Jigar, Doshi Chirag, Ramani Jaydip, Lakhia Ketav, Rathod Divyesh, Tavar Reema, Kothari Jignesh
Department of Cardiovascular and Thoracic Surgery, U.N. Mehta Institute of Cardiology and Research Center (Affiliated with B.J. Medical College), Ahmedabad, Gujarat, India.
Department of Anesthesia, U.N. Mehta Institute of Cardiology and Research Center (Affiliated with B.J. Medical College), Ahmedabad, Gujarat, India.
Interact Cardiovasc Thorac Surg. 2018 Aug 1;27(2):191-197. doi: 10.1093/icvts/ivy053.
The purpose of this study was to describe our experience with the presentation and management of cardiac echinococcosis and the outcomes.
We performed a retrospective study from January 2012 to September 2017 in 10 patients operated on for cardiac echinococcosis. There were 6 men and 4 women; the age range was 17-55 years (mean age, 35.9 ± 12.04 years). Among the 10 patients, 3 had multiple cysts and of the 7 patients with a solitary cyst, 5 cysts were in the left ventricle, 1 was in the right ventricle and 1 was in the interventricular septum. All patients were evaluated with electrocardiography, transthoracic echocardiography, computed tomography/magnetic resonance imaging of the thorax, ultrasound examinations of the abdominal organs, haemagglutination tests and histopathological examination of the cyst.
Nine operations were performed using cardiopulmonary bypass. One patient with a pericardial cyst was operated on with a beating heart with cystectomy and partial pericardiectomy. Preoperatively, all patients received albendazole for 2 weeks except for 1 patient who had an emergency operation. Albendazole was continued postoperatively in all patients for 12 weeks. There were no postoperative complications. No recurrences have been observed so far.
Cardiac echinococcosis is an infrequently encountered entity, but with clinical suspicion and early diagnosis it can be successfully managed with good outcomes.
本研究的目的是描述我们在心脏包虫病的表现、管理及治疗结果方面的经验。
我们对2012年1月至2017年9月间接受心脏包虫病手术的10例患者进行了回顾性研究。其中男性6例,女性4例;年龄范围为17 - 55岁(平均年龄35.9±12.04岁)。10例患者中,3例有多个囊肿,7例有单个囊肿,其中5个囊肿位于左心室,1个位于右心室,1个位于室间隔。所有患者均接受了心电图、经胸超声心动图、胸部计算机断层扫描/磁共振成像、腹部器官超声检查、血凝试验及囊肿组织病理学检查。
9例手术采用体外循环。1例心包囊肿患者在心脏跳动下进行了囊肿切除术及部分心包切除术。术前,除1例急诊手术患者外,所有患者均接受了2周的阿苯达唑治疗。术后所有患者继续服用阿苯达唑12周。无术后并发症。迄今为止未观察到复发情况。
心脏包虫病是一种罕见疾病,但通过临床怀疑和早期诊断,可成功治疗并取得良好效果。