Surgical treatment of an Echinococcus cyst of the interventricular septum complicated by septic endocarditis, complete atrioventricular block, and rupture into the Valsalva sinus

A 40-year-old man was emergently hospitalized because of high fever, a transient ischemic attack, and complete atrioventricular block. The diagnosis was endocarditis, cyst of the interventricular septum (IVS), and complete atrioventricular block. A temporary pacemaker was introduced, and the patient underwent surgery that included IVS cystectomy, ventricular septum plication, and aortic valve replacement. A permanent pacemaker was implanted during the early postoperative period. The patient was discharged from the medical center on day 9 after primary surgery. At the 4-month postoperative follow-up, the patient was found to be in normal condition. Patients with high temperature, heart rhythm and conduction disorders, and dyspnea of unknown etiology might be harboring Echinococcus despite the absence of primary liver or lung damage. Urgent surgical treatment is necessary even on suspicion of complicated hydatid damage to the heart.