Case Report Cardiac Hydatid Cyst: Report of Two Cases Halim Üstünsoy, MD, 1 Glyas Akdemir, MD, 2 M. Cumhur Sivrikoz, 1 Nursan Tahtacı, MD, 3 Mehmet Aksoy, MD 2 and Bülent Tunçözgür, MD 1 Departments of 1 Thoracic and Cardiovascular Surgery, 2 Cardiology and 3 Anaesthesiology, Gaziantep University Medical Faculty, Gaziantep, Turkey Cardiac hydatid cyst is life threatening but rare. It is usually asymptomatic and has potentially lethal complications, so early diagnosis with definitive treatment is life-saving. In the present article, we report two cases. The first is a 30-year-old woman with a primary large multivesicular hydatid cyst in the left ventricle. The second is a 17-year-old woman who had multivisceral involvement with a cardiac hydatid cyst, a congenital cardiac anomaly that was an atrial septal defect complicated by pulmonary hypertension. 2-D echocardiography and magnetic resonance imaging confirmed the diagnosis. Surgical treatment was performed using extracorporeal circu- lation and adjunctive albendazol therapy. (Heart, Lung and Circulation 2002; 11: 117–120) Key words: cardiac hydatid cyst, hydatid disease. ydatid disease is a parasitic infestation caused by larvae of the tape form of Echinococcus. Although several species may infect humans, Echinococus granulosus is the most common, occurring in many parts of the world including Turkey. Cardiac hydatid cysts are uncommon. The rate of incidence of cardiac hydatid cyst is 0.5–2% of all hydatid disease. 1,2 A case of hydatid cyst localised in the left ventricle and a case of multivisceral involvement including the right ventricle with atrial septal defect (ASD) are presented with their clinical eval- uation, diagnostic and surgical procedures and adjunc- tive albendazole therapy. Case Report Case 1 A 30-year-old female patient with one syncopal attack was admitted to the Cardiovascular Department, Gaziantep University Medical School. On auscultation, a systolic murmur was heard in the aortic and apical areas. Echocardiography showed a large multivesicular cyst in the left ventricular cavity (Fig. 1). The cyst was 6 × 4 × 5 cm in size. Thoracic computed tomography (CT) visualised a hypodense mass in the heart. Thoracic mag- netic resonance imaging (MRI) clearly revealed a multi- vesicular cyst in the left ventricular cavity (Fig. 2). Abdominal ultrasonography, cranial CT and electroen- cephalography (EEG) were normal. The cyst showed no changes on electrocardiogram (ECG). Laboratory exami- nation revealed a positive indirect haemagglutination test for echinococcosis (I/800) and a low haemoglobin level (9.3 g/dL). From these findings, the diagnosis of primary cardiac hydatid cyst was confirmed. We performed a left ventriculotomy in the avascular apical region using extracorporeal circulation. The cyst obstructed the outflow tract of the left ventricle and adhered to the left ventricular wall and inferoposterior part of the posteromedial papillary muscle (Fig. 3). The cyst was punctured and rinsed with hypertonic saline solution to destroy daughter cysts, then total cystectomy was performed except for the pericyst tissue that adhered to the posterior left ventricular wall. The posteromedial Correspondence: Halim Üstünsoy, Gaziantep University Medical Faculty, Department of Thoracic and Cardiovascular Surgery, Kolejtepe 27070, Lahinbey, Gaziantep, Turkey. Email: hustunsoy@yahoo.com H