Abstract Among all
cystic echinococcosis cases, only 0.5%-2% exhibit a cardiac involvement. Only 10% of these become symptomatic. Considering the long
time interval between the start of infestation and symptoms to occur, it is hard to
diagnose cystic echinococcosis. When detected, even if it is asymptomatic, intramyocardial
hydatid cyst requires surgical intervention due to
risks of
spontaneous rupture and
anaphylaxis. In
literature, no case of
hydatid cyst located in the coronary arterial wall has been reported. Twenty-two-year-old
male patient with previous
history of pulmonary
cystic echinococcosis was referred to us with typical symptoms of
coronary artery disease. Coronary
cineangiography revealed proximal left diagonal
artery (LAD) occlusion. Pre-operative
transthoracic echocardiography of the
patient planned to undergo
coronary artery bypass grafting unveiled an intracoronary calcified cystic mass. In operation, the calcified cystic mass with well-defined borders and size of 2x2 cm located within wall of proximal segment of the LAD
artery was excised and double bypass with left
internal thoracic artery (LITA) and great
saphenous vein grafts to the LAD and first diagonal
arteries, respectively, was done. Pathological
analysis of the mass revealed it to be an inactive calcified
hydatid cyst. Echinococcal
IgG-
ELISA test was positive. 12-week oral
albendazole treatment (2x400 mg/day) was launched postoperatively and the
patient was discharged on 7th postoperative day.