A 48-year-old male, from Marchigüe, VI Region of Chile, who worked as a singer during his working life.
She had a history of hypertension, dyslipidemia and a pulmonary hydatid cyst operated in 1996.
Fifteen years later, the patient presented a cerebrovascular accident, with no other cardiovascular symptoms.
Echocardiogram and chest computed tomography (CT) were performed within the etiological study, which showed a cystic mass of 4 x 3 cm in the left ventricle, with no signs of rupture.
Abdominal ultrasonography ruled out the presence of hepatic cysts.
She had no previous history or symptoms suggestive of anaphylaxis.
Subsequently, the patient presented chest pain without irradiation, with VAS intensity of 6/10.
Evaluated by cardiology in his base hospital oral anticoagulation was indicated and the patient was referred to the National Thoracic Institute with suspected cardiac hydatid disease.
The patient was admitted in good general condition, afflicted and without hemodynamic changes, with blood pressure of 130/85 mmHg and 90 beats per min. Physical examination showed no cardiac ingurgitation or cardiac murmur.
Pulmonary examination was normal.
Complete blood count revealed 21%, without leukocytosis.
The biochemical profile was normal.
The determination of IgG antibodies to Echinococcus granulosus was not performed.
The chest X-ray was normal and the electrocardiogram showed sinus rhythm, negative T waves in DII and nonspecific changes in repolarization.
Echocardiography performed in our service showed a polycystic image, oval and attached to the mass of anterolateral papillary muscles, with well-defined contours in the free wall of the left ventricle 3,2 x 2,7 cm.
These findings were confirmed by magnetic resonance imaging (MRI).
The preoperative study was completed with a normal coronary angiography.
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Surgery was performed under conservative approach and cardiopulmonary bypass, with special attention being paid to cardiac manipulation in order not to injure the cyst.
Once the aortic clamp was placed, the cyst surface was dissected, the field was isolated with soaked 10% sodium chloride solutions, and 30% saline solution was injected partially, and the cyst was punctured.
Subsequently, the cyst was opened to the anterior aspect of the left ventricle and removed the membranes and daughter vesicles.
The cavity was filled with hypertonic sodium and then partial cystectomy was performed and closure by capitonage of the remnant.
The patient had no intraoperative complications and the subsequent evolution was favorable.
In post-surgical outpatient follow-up, the patient has remained asymptomatic, with no evidence of complications or relapses and will be monitored every six months with echocardiography and serological testing for E. granulosus.
