Münacettin Ceviz

Ataturk University, Kalikala, Erzurum, Turkey

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Publications (25)30.94 Total impact

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    ABSTRACT: We report herein a hydatid cyst of the right ventricle and its two- and three-dimensional echocardiographic appearance.
    Echocardiography 05/2009; 26(4):481-4. · 1.26 Impact Factor
  • Yahya Ünlü, Necip Becit, Münacettin Ceviz, Hikmet Koçak
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    ABSTRACT: Antecedentes Los tumores del cuerpo carotídeo (TCC), especialmente los paragangliomas familiares, son neoplasias benignas poco frecuentes, que representan <0,5% de todos los tumores, y son los paragangliomas extraadrenales más frecuentes. Métodos En este estudio, se sospechó clínicamente de la existencia de TCC en 31 pacientes, pero se realizó el diagnóstico histopatológico en 28 de ellos entre 1977 y 2007 en nuestro departamento. Todos los pacientes fueron intervenidos excepto uno. La edad de los 30 pacientes tratados quirúrgicamente osciló entre los 17 y los 73 años. El síntoma común a todos los pacientes fue una masa en el cuello. Dos de los 28 pacientes con TCC tenían antecedentes de paragangliomas familiares. Resultados El TCC se confirmó mediante histopatología en 28 de estos 30 pacientes tratados quirúrgicamente; el diagnóstico de los otros 2 fue neurofibroma en uno y linfadenitis tuberculosa en el otro. Estos 2 pacientes fueron excluidos del estudio. Los TCC se resecaron sin colocar ninguna derivación temporal. Se utilizó un bisturí UltraCision en 5 pacientes para la resección tumoral; los resultados quirúrgicos fueron excelentes (fácil disección, mínima hemorragia y tiempo de intervención). Veinte pacientes fueron sometidos a resección total, en 6 se realizó la resección junto con la interposición de vena safena, en uno se realizó la resección parcial, y en uno la ligadura de la arteria carótida sin déficit neurológico resultante. Se detectó un caso de parálisis hipoglosa y una recurrencia benigna. No se observó mortalidad ni malignización. Conclusión Los TCC son neoplasias muy poco frecuentes; su tratamiento quirúrgico depende en gran medida de la habilidad y experiencia del cirujano. La importancia diagnóstica y terapéutica reside en realizar un diagnóstico precoz para proponer un tratamiento quirúrgico destinado a prevenir complicaciones y lesiones neurológicas. La resección quirúrgica suele ser el tratamiento definitivo para estas lesiones.
    Anales de Cirugía Vascular. 01/2009; 23(5).
  • Yahya Unlü, Necip Becit, Münacettin Ceviz, Hikmet Koçak
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    ABSTRACT: Carotid body tumors (CBTs), especially familial paragangliomas, are rare benign neoplasms, accounting for <0.5% of all tumors; and they are the most common extra-adrenal paraganglioma. In this study, CBTs were clinically suspected in 31 patients but diagnosed by histopathology in 28 between 1977 and 2007 at our department. All but one was operated upon. The ages of the 30 surgically treated patients ranged 17-73 years. A mass in the neck was the common symptom in all patients. Two of the 28 patients with CBTs had a familial paraganglioma history of CBT. Twenty-eight of these 30 surgically treated patients had confirmed CBT by histopathology; the diagnoses of other two patients were neurofibroma in one and tuberculosis lymphadenitis in one. These two patients were excluded from the study. CBTs were resected without a shunt procedure. UltraCision was used in five patients for tumor resection; the surgical results of these patients were excellent (easy dissection, minimal hemorrhage and time operation). Twenty patients underwent total resection, six had resection and saphenous vein interposition, one had partial resection, and one had carotid artery ligation with no resultant neurological deficit. One case of hypoglossal paralysis and one benign recurrence were detected. No mortality or malignant course was observed. CBTs are infrequent neoplasms; their surgical treatment is highly dependent on the ability and experience of the surgeon. The diagnostic and therapeutic relevance reside in making a timely diagnosis to propose a surgical treatment aimed at preventing complications and neurological damage. Surgical resection is usually definitive therapy for these lesions.
    Annals of Vascular Surgery 01/2009; 23(5):616-20. · 0.99 Impact Factor
  • Yahya Ünlü, Necip Becit, Münacettin Ceviz, Hikmet Koçak
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    ABSTRACT: Objectif Les tumeurs du corpuscule carotide (TCCs), en particulier les paragangliomes familiaux, sont de rares tumeurs bénignes représentant moins de 0,5% de toutes les tumeurs. Ils sont les plus fréquents des paragangliomes extra surrénaliens. Méthodes Dans cette étude, les TCCs étaient suspectés cliniquement chez 31 patients mais diagnostiqués en histopathologie chez 28 d'entre eux entre 1977 et 2007 dans notre institution. Tous sauf un ont été opérés. L'âge des 30 patients traités chirurgicalement variait de 17 à 73 ans. Une masse cervicale était le symptôme commun à tous les patients. Deux parmi 28 patients ayant une TCC avaient un antécédent familial de TCC. Résultats 28 des 30 patients opérés ont eu confirmation du diagnostic de TCC par l'histopathologie. Les diagnostics chez les deux autres patients étaient un neurofibrome pour l'un et une adénopathie tuberculeuse pour l'autre. Ces deux patients ont été exclus de l'étude. Les TCCs ont été réséqués sans mise en place de shunt. L'UltraCision a été utilisée pour la résection tumorale chez cinq patients ; les résultats chirurgicaux de ces patients étaient excellents (dissection facile, hémorragie et durée d'intervention minimes). Vingt patients ont eu une résection totale, 6 ont eu une résection avec greffe veineuse saphène, un a eu une résection partielle et un a eu une ligature de l'artère carotide sans séquelle neurologique. Un cas de paralysie de l'hypoglosse et une récidive bénigne ont été observés. Il n'y a eu aucun décès ni transformation tumorale. Conclusion Les TCCs sont de rares tumeurs ; leur traitement chirurgical dépend considérablement des capacités et de l'expérience du chirurgien. La discussion diagnostique et thérapeutique réside en l'établissement d'un diagnostic assez rapide pour proposer un traitement chirurgical visant à prévenir les complications et les séquelles neurologiques. La résection chirurgicale est habituellement curatrice pour ces lésions.
    Annales De Chirurgie Vasculaire. 01/2009; 23(5):667-672.
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    ABSTRACT: Brachial plexus injury is a rare complication after median sternotomy. We investigated that injury to the brachial plexus was retrospectively assessed in the results of three patients who underwent median sternotomy for open heart surgery. All patients were placed in the hands-up position after right internal jugular vein cannulation, and the internal mammary artery was prepared for all of those. Nerve conduction measurements and electromyography were performed besides neurological examination. Brachial plexus injury was detected in three cases (0.5%) of 575 patients who underwent coronary artery bypass grafting with median sternotomy. The main symptoms were continuous pain, and motor and sensory disturbances at the affected upper extremity (left arm in all cases). The common feature was that in all cases the left internal mammary artery was harvested. While the symptoms were relieved in two patients about six months after the operation, the other one had intractable pain and paresthesia. The most important measure is careful sternal retraction and use of the hands-up position for the low incidence and benign course of brachial plexus problems. Inappropriate sternal retraction during preparation of internal mammary artery should be avoided.
    Interactive Cardiovascular and Thoracic Surgery 05/2007; 6(2):235-7. · 1.11 Impact Factor
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    ABSTRACT: We report the case of a patient with a pseudoaneurysm of the left coronary ostial anastomoses diagnosed 6 years after a Bentall procedure with coronary button anastomoses had been performed. Preoperatively, the pseudoaneurysm of the ascending aorta was diagnosed by transesophageal echocardiography and multislice tomography, and the diagnosis was confirmed by surgery. Intraoperatively, the dehiscence of the button anastomosis of the left coronary artery was determined. The operative technique for the repair of the left coronary anastomosis dehiscence was direct closure through a sternotomy using extracorporeal circulation. The patient was discharged on the twelfth day without problems. In conclusion, we demonstrated that the patient with a pseudoaneurysm after a conduit operation of the ascending aorta can be prediagnosed by using echocardiography and multislice tomography.
    Heart Surgery Forum 02/2007; 10(3):E191-2. · 0.63 Impact Factor
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    ABSTRACT: The types of fistulae used and their complication rates are important for the hemodialysis patients. We aimed to compare retrospectively the primary and secondary patency rates and complications of upper extremity arteriovenous fistulae. Between 1984 and 2005, a total of 1,233 upper extremity arteriovenous fistulae were created in 920 patients. The mean age was 42 +/- 21 years. The fistulae were divided into the 3 groups; 588 radiocephalic, 205 brachiocephalic, and 127 were created by polytetrafluoroethylene graft. The fistulae types were evaluated with regard to their primary-secondary patency rates and complications. There was a significant difference with regard to development of thrombosis in radiocephalic group compared to other two groups, respectively, p = 0.0122, p = 0.0091. In brachiocephalic fistulae group, edema and steal phenomenon were statistically significant (p < 0.0001). The aneurysm formation was statistically significant in polytetrafluoroethylene fistulae graft group (p < 0.0001). During 6 months, 2 and 5 years period, while primary patency rate was higher in three fistulae types, in radiocephalic fistulae both primary and secondary fistulae patency rates were lower (p < 0.05). To create successful arteriovenous fistulae with long-term patency, appropriate veins of patients should be carefully preserved; thus initially a distal site should be preferred, and in case of failure the next fistulae should be created proximally. In case of failure of forearm fistulae, primary fistulae with autogenous veins should be tried at the upper arm first, and if this also fails, fistulae formation with synthetic grafts should be considered.
    The Tohoku Journal of Experimental Medicine 10/2006; 210(2):91-7. · 1.37 Impact Factor
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    ABSTRACT: This is a retrospective clinical study on adult patients treated surgically for Buerger's disease in our region. In our clinic, 344 patients with Buerger's disease were surgically treated between 1980 and 2004. The major complaints included foot coldness in 312 (90.6%) patients, color changes in 290 (84.3%), rest pain in 160 (46.5%), claudication in 166 (48.2%) and necrotic ulcers in 185 (53.1%). Lumbar sympathectomy was made in 278 (80.2%) patients, thoracic sympathectomy in 7 (2.2%), thoracic and lumbar sympathectomy in 12 (3.6%), lumbar sympathectomy and femoropopliteal or femorotibial bypass in 30 (9%), and femoropopliteal or femorotibial bypass in 17 (5%). Color changes were improved in 230 (79.3%) patients, food coldness were decreased in 288 (92.3%) and rest pains were improved in 43 (26.8%). Intermittent claudications decreased in 132 of 166 patients. Necrotic ulcers healed in 30 of 185 patients. Amputation was made totally in 155 (53%) patients in 10 years. As a nonatherosclerotic, segmental, inflammatory disease, Buerger's disease is casually related to tobacco use. The main goal is to discontinue the use of tobacco. Sympathectomy may be helpful in healing the ulcers and decreasing the symptoms. Vascular reconstruction is rarely possible for patients with Buerger's disease due to segmental involvement and distal nature of the disease.
    International Journal of Cardiology 08/2006; 111(1):147-53. · 6.18 Impact Factor
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    ABSTRACT: The provision and maintenance of vascular access remains a major cost to end-stage renal failure programs. In addition, vascular access occlusion, results in significant morbidity in hemodialysis patients. Age, gender, diabetes mellitus, malignancy, smoking habits, administration of heparin per hemodialysis session, previous dialysis catheter insertion, number of hemodialysis sessions and location of the fistula may be associated with survival of the primary arteriovenous fistula. We examined the effects of various factors on fistulas in 412 chronic renal insufficiency patients. From 1995 to 2004, 412 arteriovenous fistulas were created by the Department of Cardiovascular Surgery at the Medical Faculty of Atatürk University for hemodialysis. The mean age of the patients was 45 years (range 6 to 62 years). We evaluated the effects of various factors for patency rates in the patients who had primary arteriovenous fistulas. Primary patency was defined as the duration of fistula patency without revision. Twenty-eight patients (6.7%) with ischemic cardiac disease did not require surgical interference. Analyzed data were age, gender, smoking habits, diabetes mellitus, malignant neoplasm, previous dialysis catheter insertion, number of hemodialysis sessions, and fistula location. In 298 patients, where lower-arm radiocephalic fistulas were created, the fistula patency was 74.1%, 64.2%, 49.8%, 33.7%, and 4.1% after 1, 2, 3, 4, and 5 years, respectively, in the other 114 patients, where upper-arm fistulas were created, these rates were 84.0%, 72.2%, 53.3%, 39.8%, and 12.3%, respectively. There was no significantly difference between the upper-arm fistulas and the lower-arm fistulas statistically (p = 0.069). Factors affecting the primary patency of arteriovenous fistulas were diabetes mellitus (p = 0.0001), hemodialysis counts > or =3 per week (p < 0.0005), presence of malignancy (p < 0.0005), previous catheter insertion (p < 0.0007), and administration of heparin per hemodialysis session (p = 0.0008). While primary arteriovenous fistula patency was shortened in chronic renal insufficiency patients with diabetes mellitus, presence of malignancy, and previous catheter insertion, patency was longer in patients with heparin used for hemodialysis and hemodialysis count per week (> or =3).
    Renal Failure 01/2006; 28(4):275-81. · 0.94 Impact Factor
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    ABSTRACT: A 31-year-old woman who had undergone aortic and mitral valve replacement 1 year previously was hospitalized with suspected prosthetic valve endocarditis. Freestyle stentless aortic xenograft was successfully replaced using freestanding total aortic root replacement techniques at the left ventricular outflow tract position, and aorta-to-right coronary artery bypass was also applied with a saphenous vein graft. The patient developed multiple systemic problems during the preoperative and postoperative periods and was successfully treated with intensive interventions. She was discharged at the postoperative fourth month, and the following 28 months were uneventful.
    Heart Surgery Forum 02/2005; 8(1):E52-4. · 0.63 Impact Factor
  • The Heart Surgery Forum 02/2005; 8(1). · 0.46 Impact Factor
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    ABSTRACT: The aim of this study was to investigate whether or not there is an increase in serum total and free prostate specific antigen levels (t-PSA, f-PSA) in patients with and without benign prostatic hyperplasia (BPH) undergoing extracorporeal circulation during cardiovascular bypass. The study included a total of 50 men. Of these, 35 patients underwent elective coronary artery bypass grafting with extracorporeal circulation [with (n=20, group I) and without (n=15, group II) BPH]. Another 15 patients underwent renal or ureteral surgery (group III) and served as a control group. Serum t-PSA and f-PSA levels were measured before surgery and 3 h and 3 days after surgery. All patients underwent urethral catheterization 24 h before surgery. In groups I and II, patients had an increase in t-PSA 3 h after surgery compared to baseline values (p=0.0001 and p=0.011, respectively). Also, 3 days after surgery, mean t-PSA levels were higher than baseline levels (p=0.004) in group I. Serum t-PSA levels were higher at 3 h than at day 3 in groups I and II (p=0.003 and p=0.02, respectively). Mean serum f-PSA levels obtained 3 h after surgery were increased in both groups I and II when compared to baseline values (p=0.0001 and p=0.001, respectively). There was no significant difference between f-PSA values before and 3 days after surgery in all groups. In the control group, there was no significant increase in either serum t-PSA or f-PSA levels obtained at different times. There was a modest increase in the percentage of free prostate specific antigen (% f-PSA) 3 h after the operation in group II (p=0.025); the values returned to baseline within 3 days. It was suggested that t-PSA and f-PSA serum levels increase due to extracorporeal cardiopulmonary circulation as a consequence of ischemic damage to the prostate. In patients with BPH, this rise may be higher than in those without BPH, because BPH patients generally have larger prostate volumes that may be more vulnerable to ischemic damage. Because f-PSA has a shorter half-life, postsurgical levels of f-PSA may not show this ischemic damage to the prostate during the late postoperative period and f-PSA appears to be cleared more rapidly than t-PSA.
    Clinical Chemistry and Laboratory Medicine 02/2005; 43(1):64-7. · 3.01 Impact Factor
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    ABSTRACT: We describe a 57-year-old female patient with left atrial giant myxoma and peroperative defined mitral insufficiency who underwent surgery with a diagnosis of a left atrial myxoma without accompanying mitral insufficiency. Although no clinical findings of mitral insufficiency were noticed preoperatively, after myxoma resection moderate mitral insufficiency was observed during surgery. Mitral insufficiency was repaired with annuloplasty. The patient recovered without complication.
    Heart Surgery Forum 02/2004; 7(4):E269-70. · 0.63 Impact Factor
  • Hikmet Koçak, Necip Becit, Münacettin Ceviz, Yahya Unlü
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    ABSTRACT: In this report, a case of a left ventricular (LV) pseudoaneurysm due to a previous myocardial infarction, which was repaired successfully, is described. A 62-year-old man, with a history of acute anterior wall myocardial infarction 6 months previously, was admitted with the complaints of acute dyspnea and palpitation. Echocardiography revealed an LV aneurysm, and ventriculography showed ventricular dysfunction and an LV pseudoaneurysm. Coronary angiography showed total occlusion of the proximal segment of the left anterior descending artery with a very thin lumen and insufficient retrograde filling. Under cardiopulmonary bypass and beating heart, the pseudoaneurysm was resected and the defect on the ventricular free wall was closed by the remodeling ventriculoplasty method of Dor. Histopathologic examination of the resected material confirmed the diagnosis of pseudoaneurysm. The postoperative course of our patient was uneventful. He was discharged on the ninth postoperative day.
    Heart and Vessels 08/2003; 18(3):160-2. · 2.13 Impact Factor
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    ABSTRACT: This report describes our experience in performing mitral valve replacement and tricuspid annuloplasty via a right mini-thoracotomy in a patient with tracheostomy. A 24-year-old woman was admitted with shortness of breath and palpitations. She had subglottic tracheal stenosis and tracheostomy due to tracheal intubation of long duration. Echocardiography revealed chronic severe mitral and tricuspid valve regurgitation. We planned to perform at first the cardiac, and then the tracheal operation, because her left ventricular function was worsening. To eliminate the potential complications of sternotomy in patients with tracheostomy, we used right mini-thoracotomy. We performed mechanical mitral valve replacement for the mitral valve and De Vega annuloplasty for the tricuspid valve. The patient was transferred to the tracheal surgery clinic after the 20th day. Tracheal resection and anastomosis were performed in this department. Three months later, the patient was asymptomatic. We believe that the right mini-thoracotomy approach is a good technique for mitral valve replacement in patients with tracheostomy.
    Heart and Vessels 06/2003; 18(2):103-4. · 2.13 Impact Factor
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    ABSTRACT: Adequate care of a hemodialysis patient requires constant attention to the need to maintain vascular access (VA) patency. VA complications are the main cause of hospitalization in hemodialysis patients. The native arteriovenous fistula (NAVF), synthetic arteriovenous grafts fistula (GAVF) and silastic cuffed central venous catheters (CVCs) are used for permanent vascular access (PVA). CVCs are primary the method of choice for temporary access. But using this access modality is increasing more and more for PVA in elderly hemodialysis patients and when other PVA is not possible. The primary aim of this study is to investigate survivals and complications of the CVCs used for long-term VA. We prospectively looked at 92 CVCs (Medcomp Ash Split Cath, 14 FR x 28 cm (Little, M.A.; O'Riordan, A.; Lucey, B.; Farrell, M.; Lee, M.; Conlon, P.J.; Walshe, J.J. A prospective study of complications associated with cuffed, tunnelled hemodialysis catheters. Nephrol. Dial. Transplant. 2001, 16 (11), 2194-2200) with Dacron cuff) inserted in 85 (50 females, 35 males) chronic hemodialysis patients (the mean age: 56.6 +/- 14.1 years) from July 1999 to January 2002. The overall survival and complications were followed up. Furthermore, the patients were evaluated for demographic and clinical characteristics. Data were analysed by chi-square, Wilcoxon rank and Kaplan-Meier survival tests. The median duration of CVC survival was 289 days (range: 10-720). Eleven (11.9%) CVCs were removed due to complications. In 79 (92.9%) patients, 1, in 5 (5.8%) patients, 2 and in 1 patient, 3 CVCs were inserted. Of the 85 patients, 56 have CVCs functioning. In addition, 27 (31.76%) patients have CVCs functioning for over 12 months, 17 (20%) patients have CVCs functioning for 6 months. The total incidence of CVC related infections was 0.82 episodes/1000 catheter days. Besides, thrombosis was occurred in 10 (10.8%) CVCs. The most frequent indications for CVC removal were patient death (69.4%), thrombosis (16.6%) and CVC-related infections (13.8%). CVCs are primarily used for temporary access. But this study indicates that CVC may be a very useful alternative permanent vascular access for hemodialysis patients when other forms of vascular access are not available.
    Renal Failure 06/2003; 25(3):431-8. · 0.94 Impact Factor
  • Yahya Unlü, Münacettin Ceviz, Pinar Polat
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    ABSTRACT: A case demonstrating a false aneurysm in the palmar segment of the ulnar artery caused by a Fogarty's catheter, which had been inserted during a thrombectomy, is described. The diagnosis was suspected based on a clinical examination, and duplex ultrasonography and computed tomography (CT) confirmed an aneurysm in the palmar segment of the ulnar artery. The patient underwent a successful aneurysmectomy with end-to-end reanastomosis.
    Surgery Today 02/2003; 33(2):148-50. · 0.96 Impact Factor
  • Yahya Unlü, Salim B Tekin, Münacettin Ceviz, Ahmet Balci
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    ABSTRACT: Diffuse large B-cell lymphoma is a very common, highly invasive lymphoma, which typically presents as a rapidly enlarging symptomatic mass with local compression of vessels or airways, and often is involved with the peripheral nerves and the destruction of bone. Vascular invasion is extremely rare. We herein describe the case of a successfully treated 42-year-old man who presented with massive bleeding due to a rupture of the axillary artery and vein involvement due to lymphoma.
    Surgery Today 02/2003; 33(1):72-4. · 0.96 Impact Factor
  • Necip Becit, Yahya Unlü, Hikmet Koçak, Münacettin Ceviz
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    ABSTRACT: We report a case of coronary artery bypass grafting (CABG) using the left internal mammary artery (LIMA) and a saphenous vein graft in a 36-year-old man with Buerger's disease. He was hospitalized in the coronary intensive care unit with a diagnosis of acute myocardial infarction. His coronary angiography showed total occlusion of the proximal segment of the left anterior descending artery (LAD) and right coronary artery. Left ventricular dysfunction was detected by ventriculography. The patient had undergone bilateral sympathectomy of the lumbar branches for distal arterial occlusions due to thromboangiitis obliterans 12 years previously. Under cardiopulmonary bypass and aortic cross-clamping, we performed endarterectomy and a complex bypass procedure to LAD. Aorta-right coronary artery bypass was also applied. A histopathological study of an endarterectomy specimen showed characteristic features of thromboangiitis obliterans. The postoperative course was uneventful and the patient was discharged on the ninth postoperative day.
    Heart and Vessels 08/2002; 16(5):201-3. · 2.13 Impact Factor
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    ABSTRACT: Three patients diagnosed with hydatid cysts of the heart underwent surgical treatment. The cysts were enucleated and the cavities were closed in 2 cases by plication and obliteration. In one case, the cystic cavity was closed with biologic glue. The outcome was satisfactory in all 3 patients. Postoperative treatment with albendazole is recommended.
    Asian cardiovascular & thoracic annals 04/2002; 10(1):66-8.