Dans certaines contrées, l’hydatidose reste un problème de santé publique. Cependant, le kyste hydatique du cœur est rare. Répertorier les cas de kystes hydatiques du cœur opérés dans notre centre de chirurgie cardiovasculaire, afin d’analyser leurs aspects diagnostiques et thérapeutiques. Il s’agit d’une étude rétrospective et descriptive de cas consécutifs et non sélectionnés. De 1967 à l’an 2006, 25 cas de kystes hydatiques du cœur ont été opérés dans le centre hospitalier Siyami-Ersek en Turquie. Les kystes hydatiques se sont révélés être intracavitaires dans dix cas (sous-endocardiques). Chez les autres patients, les kystes étaient extracavitaires mais demeuraient toutefois intrapéricardiques. Chez deux patients les kystes combinaient les deux formes. La moyenne d’âge des patients était de 31±9,2 ans, la majorité des patients étant des femmes avec un rapport F/H 17/8. Douze patients souffrant de kystes hydatiques intracavitaires et deux patients ayant des kystes extracavitaires ont été opérés sous circulation extracorporelle. Un seul patient est décédé. De tous ces patients, un seul a souffert d’une récidive du kyste. Même si la littérature tend à montrer que l’hydatidose cardiaque est plus fréquente du côté gauche du cœur, nous avons constaté que l’incidence du kyste hydatique du côté droit du cœur est probablement plus élevée. Il semble donc judicieux de clamper l’artère pulmonaire pendant la résection du kyste pour empêcher une migration pulmonaire. Une intervention chirurgicale attentive pendant la résection et le capitonnage de la cavité sont essentielles pour empêcher une récidive du kyste hydatique.

In some countries, Hydatidosis is a common public health problem but cardiac hydatid cysts are rarely observed. The evaluations of operative results and follow up of cardiac hydatid cases. Twenty-five consecutive unselected patients suffering from cardiac hydatidosis and operated on between 1967 and 2006 in Siyami Ersek Cardiothoracic and Vascular Surgery Center were retrospectively analyzed. In 10 of these patients the hydatid cyst was intracardiac, while in 13 patients cysts were extracavitary but located into the pericardium. In 2 patients the hydatid cyst was both intra and extracavitary. Mean age of the patients was 31+/-9.2. The female/male ratio was 17/8. The 12 patients with intracavitary and 2 patients wit extracavitary hydatid cysts were operated on with the aid of extracorporeal circulation. One patient died postoperatively. In one patient recurrence of the hydatidosis was observed. The majority of cases in previous publications were located in the left side of the heart. In our series, most were located in the right heart. In such cases clamping the pulmonary artery is mandatory to prevent pulmonary migration. Careful resection is important for prevention of recurrence.

OBJECTIVE:The goal was to review our experience in the management of carotid body tumours.MATERIAL AND METHODS:A retrospective study was performed of patients in whom carotid body tumour was diagnosed between 1998 and 2005. Data were retrieved from hospital discharge files.RESULTS:Fourteen patients were operated on. There were five patients in Shamblin class I, 4 in class II, and 5 in class III. Duplex examination was performed in all patients. Computerized tomography scans were performed in eight (57%) patients and magnetic resonance imaging scans in five patients (36%). Angiography was performed in all patients, preoperative embolization was attempted in 5 (36%). The blood loss for these patients was not less than for those without embolization. Three patients (21%) had postoperative cranial nerve deficits. All the deficits resolved. The internal carotid artery was injured in two patients and the external carotid artery was injured in three patients (36%). No stroke occured.CONCLUSION:Surgical resection is the treatment of choice for carotid body tumours. Observation of these tumours is not recommended because progressive growth is associated with increased risk of neurological deficits. Early surgical management is recommended to avoid neurological deficit due to a Shamblin class III tumour. We also do not recommend embolization.

Yapici, N.; Çoruh, T.; Orhan, G.; Sargin, M.; Yüksel, M.; Maçika, H.; Kurç, E.; Yücel, O.; Aka, S. A.; Aykaç, Z. Author Information