Published Paper Details:

The hydatidosis is due to the accidental development of Echinococcus granulosus larvae in humans. It is a public health problem in endemic countries such as Maghreb countries, with a preferential localization in the liver and lungs. The cardiac localization represents 0,5 to 2 % of all the hydatic localizations and remains polymorphic and potentially fatal . We present the case of a 42 year old man, living in the rural environment, who underwent two surgical operations for left than right pulmonary hydatidosis, than was reoperated for a left pulmonary relapse. The patient was admitted with a chest pain associated with an exertional dyspnea evolving for about 6 months . The complete blood count, the serological hydatic results, and the analysis of the liquid of bronchoaspiration were negative. Nevertheless, the chest X-ray showed a deformation of the cardiac silhouette and a cardiomegaly. The thoracic angioscanner revealed a left ventricular hydatic cyst sitting at its anterior wall between the anterior interventricular artery and the circumflex artery. There was a second hydatic cyst located at the thymic lodge measuring about 10 cm of major axis. The echocardiography showed the presence of a cardiac mass in the lateral wall of the left ventricle, confirmed by the MRI, which revealed: two hydatid cysts: the first one was intramyocardial, and the second one was located at the thymic lodge. The coroscanner showed a close contact of the cyst with the anterior interventricular artery. The patient had a pericystectomy of the hydatid cyst of the thymic lodge and resection of the anterior wall of the left ventricular cyst with a reconstruction of the left ventricular anterior wall using a double patch in Bovine pericardium and Dacron under extra-corporeal circulation. The postoperative management was simple. Through this rare case, we remind the possibility of a cardiac localization of the hydatid cyst, and the therapeutic difficulties as it relates to its intra-myocardial development.