Off-Pump Resection of Giant Intramural Left Ventricular Hydatid Cyst by Pleuropericardial Approach: a Case Report

ABSTRACT Primary cardiac hydatid cyst is a rare and fatal pathology, especially when involving the left ventricular free wall. A 44-year-old male was diagnosed with large intramural left ventricular hydatid cyst with wall thickness of 6 mm at the thinnest point. Cyst was accessed through pleuropericardial approach (left pleura opened, followed by entry into cyst directly through adjacent pericardium without removing the pericardial adhesions) which resulted in easy entry into the cyst, mitigating the risk of mechanical injury. This case report highlights that with detailed evaluation, cardiac hydatidosis can be addressed with off-pump technique, reducing the anaphylaxis risks and cardiopulmonary bypass-related effects.

摘要：原发性心脏包虫囊肿（Primary cardiac hydatid cyst）是一种罕见且致命的病理状态，尤其当病变累及左心室游离壁时。本研究报告1例44岁男性患者，其被诊断为巨大壁内型左心室包虫囊肿，囊壁最薄处厚度为6 mm。术者采用胸膜心包入路完成囊肿穿刺：切开左侧胸膜后，直接经邻近心包穿刺囊肿，未剥离心包粘连，此举实现了囊肿的顺利暴露，降低了机械性损伤的风险。本病例报告表明，通过细致的术前评估，心脏包虫病可采用非体外循环技术（off-pump technique）进行治疗，从而降低过敏反应风险及体外循环（cardiopulmonary bypass）相关并发症的不良影响。