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All Journal Majalah Kedokteran Bandung Folia Medica Indonesiana Jurnal Kedokteran Health Notions Manuju : Malahayati Nursing Journal Jurnal Respirasi (JR) JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Majalah Biomorfologi (Biomorphology Journal) Cardiovascular and Cardiometabolic Journal (CCJ) JKKI : Jurnal Kedokteran dan Kesehatan Indonesia Cerdika: Jurnal Ilmiah Indonesia Jurnal Widya Medika
Soebroto, Heroe
Department Of Cardiothoracic And Vascular Surgery, Faculty Of Medicine Universitas Airlangga, Dr Soetomo General Academic Hospital, Surabaya Indonesia
Humanities Biochemistry, Genetics & Molecular Biology Dentistry Economics, Econometrics & Finance Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Other

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TEG's Utility to Detect Hypercoagulability in Adult Patients at Post-Cardiac Surgery Using Cardiopulmonary Bypass in ICU Hildegardis Dyna Dumilah; Hartono Kahar; Arifoel Hajat; Philia Setiawan; Heroe Soebroto
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1615

Abstract

The use of Cardiopulmonary Bypass (CPB) in adult patients of cardiac surgery disrupts the coagulation system. The most common complication of the coagulation system is bleeding; however, that does not rule out the possibility of a dangerous hypercoagulation condition. A quick and precise coagulation test can provide clues for clinicians to predict future hemostatic disorders or determine interventional therapy. aPTT and PT are standard laboratory tests, which are limited to detect a deficiency of coagulation factors. Thromboelastography (TEG) test (R time, K time, α angle, MA, and LY30) provides an overview of the entire coagulation and fibrinolysis process with faster results. A 2.7 mL citrate blood sample was taken and tested in a TEG®5000 device, then centrifuged. The plasma was then tested for aPTT and PT using the Sysmex CS-2100i device. Bleeding volume was measured from chest drain 1-2 hours in the ICU after chest closure in the operating room. Bleeding criteria were as follows: > 1.5 mL/kg/hour for 6 hours consecutively in 24 hours or > 100 mL/hour. The results showed 30 patients with no clinically significant bleeding. A significant correlation was found between PT and bleeding volume at IV hour (p=0.008, r= 0.472). There was no correlation between aPTT and TEG (R time, K time, α angle, MA, and LY30) with the bleeding volume at I, II, III, and IV hours. There was a hypercoagulation indication of the TEG test of 56.7%, which showed clinical importance for the patient. PT can be used to analyze changes in bleeding volume at IV hour and TEG is more superior to detect hypercoagulability of adult patients after cardiac surgery with CPB.  
Lung Cancer: A Literature Review Yan Efrata Sembiring; Wiwin Is Effendi; Jeffrey Jeswant Dillon; Heroe Soebroto; Dhihintia Jiwangga Suta Winarno; Puruhito Puruhito; I Gusti Agung Made Adnyanya Putra; Abed Nego Okthara Sebayang; Sri Pramesthi Wisnu Bowo Negoro
Jurnal Respirasi Vol. 9 No. 3 (2023): September 2023
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v9-I.3.2023.246-251

Abstract

Lung cancer is a cancer whose onset starts in the lungs where there is an abnormal cell growth that is very fast and uncontrolled. The abnormal cell growth is triggered by deoxyribonucleic acid (DNA) damage, including deletions in the DNA section, inactivation of tumor suppressor genes, activation of proto-oncogenes to oncogenes, the absence of apoptosis, and the activity of the telomerase enzyme. Lung cancer is initiated by oncogeneous activity and inactivation of tumor suppressor genes. Oncogenes are genes that help cells grow and divide and are believed to cause a person to develop lung cancer. In general, lung cancer is divided into two types, namely non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). World Health Organization (WHO) classifies lung cancer based on histopathology into 4 major cell types, namely SCLC, NSCLC which includes adenocarcinoma, squamous cell carcinoma (SCC), and large cell carcinoma (LCC). The difference between the two is that SCLC has a higher aggressiveness than NSCLC. Cancer treatment is based on the type, size, location and stage of the cancer, as well as the patient's overall condition.
Efficacy, Safety, and Clinical Outcomes of Splenorenal Shunt Surgery as a Therapeutic Intervention for Portal Hypertension Patients Yan Efrata Sembiring; Heroe Soebroto; Ito Puruhito; Dhihintia Jiwangga Suta Winarno; I Gusti Agung Made Adnyanya Putra2; Sri Pramesthi Wisnu Bowo Negoro; Ketut Putu Yasa; Jeffrey Jeswant Dillon
Folia Medica Indonesiana Vol. 59 No. 3 (2023): September
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/fmi.v59i3.48843

Abstract

Highlights: 1. This study systematically reviewed the efficacy, clinical outcomes, and safety of the splenorenal shunt procedure with a comprehensive and meticulous approach.2. The splenorenal shunt procedure is an innovative surgical intervention that offers a viable option for the management of portal hypertension.   Abstract Portal hypertension is the second most common gastrointestinal bleeding in cirrhosis and non-cirrhosis patients. The splenorenal shunt surgery is a potential intervention that may be considered for portal hypertension patients with clinical symptoms such as upper gastrointestinal bleeding caused by the rupture of gastro-esophageal varices. In this study, the researchers aimed to analyze the efficacy, clinical outcomes, and safety of splenorenal shunt surgery in portal hypertension patients. The sources were obtained from electronic search databases, including PubMed, Google Scholar, and ScienceDirect, using the keywords "Efficacy," "Safety," and "Clinical Outcomes." in relation to splenorenal shunt surgery in portal hypertension patients. The researchers set specific criteria for inclusion and exclusion to select the articles. This systematic review revealed the efficacy of the splenorenal shunt procedure with favorable outcomes. The success rate of splenorenal shunt surgery in reducing the clinical symptoms of portal hypertension varied between 66% and 100%. The prevailing complications observed in this study were shunt thrombosis, rebleeding, and thrombocytopenia. However, notable improvements could be achieved with general treatment. In terms of short- and long-term clinical outcomes, the splenorenal shunt procedure demonstrated favorable results. It can be concluded that splenorenal shunt surgery provides excellent clinical outcomes and should be considered a viable treatment option for patients with both cirrhotic and non-cirrhotic portal hypertension.
Changes in Nutritional Status of Children Under Five with Acyanotic Congenital Heart Disease Left to Right Shunt Type After Defect Closure by Catheterization Marsa Hendra Utomo; Taufiq Hidayat; Heroe Soebroto
Cardiovascular and Cardiometabolic Journal (CCJ) Vol. 5 No. 1 (2024): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v5i1.2024.11-22

Abstract

Highlights: 1. The nutritional status of children with CVD after therapy is interesting to discuss especially because children antibody varies. 2. Changes in their nutrition intake after the surgery would help for future treatments with related disease and same operation. - Background: One of the impacts that occur in patients with congenital heart disease (CHD) is malnutrition. Malnutrition will affect the growth of the child. Closure therapy with catheterization can improve nutritional status after a few months. This study aims to determine the nutritional status of toddlers with simple left to right shunt-type acyanotic CHD before and after closure therapy with catheterization. Material and Methods: This study is an analytical observational study with a retrospective cohort method using medical record data involving pediatric patients less than 5 years old with simple left to right shunt-type acyanotic CHD who received closure by catheterization at Dr. Soetomo General Hospital from January 2020 to December 2020. Results: From 10 samples, the characteristics of the most samples were women (90%), age group 2-5 years (60%), and PDA abnormalities (50%). In addition, nutritional status after closure by catheterization improved. Conclusion: There was an improvement in nutritional status (W/H) after defect closure with catheterization in patients aged less than 5 years with simple left to right shunt type acyanotic CHD within several months.
THE HDL LEVEL IN DIABETIC FOOT ULCER PATIENTS WITH AND WITHOUT AMPUTATION AT DR. SEOTOMO GENERAL ACADEMIC HOSPITAL SURABAYA Ahmed Eliaan Shaker Abuajwa; Hermina Novida; Heroe Soebroto; Yan Efrata Sembiring
Majalah Biomorfologi Vol. 33 No. 1 (2023): MAJALAH BIOMORFOLOGI
Publisher : Universitas Airlangga, Surabaya, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mbiom.v33i1.2023.30-37

Abstract

Highlights1. Diabetes mellitus is a category of metabolic disease characterized by uncontrolled hyperglycemia.2. This study revealed no statistically significant differences in total cholesterol, TG, LDL, HDL, or LDL/HDL ratio between amputated and non-amputated DFU patients. AbstractBackground: Diabetic foot ulcers (DFU) are microvascular and macrovascular consequences of diabetes and are associated with neuropathy, vascular disease, and immunosuppression. Increased blood glucose levels may result in the glycosylation of proteins in the nerve cells of the foot, leading to ischemia and cellular disturbances that can damage muscular, sensory, and autonomic neurons. Objective: To compare the lipid profiles of amputated and non-amputated DFU patients. Material and Method: This was a cross-sectional, analytic, retrospective research using total sample approach to analyze the medical records of all diabetes patients admitted to Dr. Soetomo General Academic Hospital between February 2018 and December 2020, with or without amputation. Result: The average age of DFU patients at Dr. Soetomo General Academic Hospital was 55.6 9.4 years, and the majority of patients were female (57%). Diabetic foot ulcers were most prevalent in the age group ≥50 years old (74%), amputated DFU patients had larger mean total cholesterol, TG, LDL, and HDL than non-amputated DFU patients, although the difference was not statistically significant. While the mean LDL/HDL ratio was greater in non-amputated DFU patients, the difference was statistically insignificant. The HDL level was low in 84% of amputated DFU patients, whereas in non-amputated DFU patients it was 81%. Conclusion: This research showed no significant variation in total cholesterol, TG, LDL, HDL, or the LDL/HDL ratio between amputated and non-amputated DFU patients. Most DFU patients with and without amputations had low HDL values.
Profile of Primary Arteriovenous Fistula Failure in End-Stage Renal Disease Patients on Hemodialysis at Dr. Soetomo General Academic Hospital, Surabaya Reviano, Moses Orvin; Sembiring, Yan Efrata; Widodo, Widodo; Soebroto, Heroe
JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Vol. 16 No. 1 (2025): Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/juxta.V16I12025.43-49

Abstract

Highlights: Arteriovenous fistula is preferred for dialysis vascular access. Twenty-eight (4.8%) cases had primary arteriovenous fistula failure.   Abstract Introduction: Primary arteriovenous fistula failure in Indonesia is still relatively high, and end-stage renal disease patients are prioritized to have arteriovenous fistula as their main vascular access for hemodialysis. This study aimed to determine the primary arteriovenous fistula failure profile in end-stage renal disease patients on hemodialysis at Dr. Soetomo General Academic Hospital, Surabaya. Methods: This was a descriptive retrospective study. The population was primary arteriovenous fistula failure patients. A total sampling method was used from the medical records of Dr. Soetomo General Academic Hospital, Surabaya, from January 2021 until January 2023. The research variables were gender, age, diabetes mellitus (DM) history, hypertension (HTN) history, duration of catheter double-lumen (CDL) usage before arteriovenous fistula placement, incidence of early thrombosis, and incidence of maturation failure. Data was analyzed with Microsoft Excel 2018. Results: There were 28 primary arteriovenous fistula failure cases from 580 surgical procedures performed in the research period (4.8%). The dominant results were: 15 female patients (54%), 25 non-elderly patients (89%), 16 non-DM patients (57%), 14 patients in both HTN and non-HTN (50%), 20 prolonged CDL patients (71%), followed by 7 patients that did not use CDL (25%), 28 maturation failure patients (100%), and 18 non-early thrombosis patients (64%). Conclusion: Female gender, duration of CDL usage, and maturation failure were the more prominent characteristics in this research profile. Meanwhile, the less prominent characteristics were old age, DM history, HTN history, and early thrombosis.
Predictive Factors of Amputation for Post-Bypass Surgery on Vascular Trauma Patients Kusworo, Afila Reza; Soebroto, Heroe; Suroto, Heri
Majalah Kedokteran Bandung Vol 56, No 1 (2024)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v56.3107

Abstract

n Indonesia, most vascular trauma is linked to traffic collisions. According to the Statistics Indonesia (Badan Pusat Statistik, BPS), there were 116,411 accidents in 2019. Limb salvages become important in  vascular trauma, which is performed through, among others, vascular bypass surgery. However, secondary amputation still occurs after vascular bypass. This study aimed to determine the predictors of secondary amputation after vascular bypass due to vascular trauma. This study used descriptive analysis of medical records and univariate analysis. Medical records of patients with vascular trauma underwent vascular bypass in Dr Soetomo Regional Hospital, Indonesia, from January 2018 to December 2020 were collected. Independent variables were age, MESS, time interval between the incident of trauma to the first incision of bypass surgery, penetrating and blunt injury, injured arterial segment, multiple injuries, and obesity. The dependent variable was secondary amputation. Fisher Exact Test was used to analyze the correlation between dependent and independent variables. Results showed a significant difference between patients with a MESS score of >7 and those with a MESS score of  ≤7 (p=0.044), where more patients with a MESS score of >7 experienced secondary amputation. Other variables showed no significant difference (p>0.05). This study concluded that MESS could be used as a predictor of secondary amputation in vascular trauma after vascular bypass. Further studies using multivariate analysis and a larger sample need to be conducted to get further insights on this phenomenon.
COMPLETE REPAIR OF TETRALOGY OF FALLOT (TOF) ON BEATING HEART SURGERY WITHOUT AORTIC CROSS CLAMPING : REPORT OF A CASE Gerardo AK Laksono; Heroe Soebroto; Paul L Tahalele
JURNAL WIDYA MEDIKA Vol. 7 No. 2 (2021): October
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33508/jwm.v7i2.3516

Abstract

Introduction: Reperfusion injury is a well-known phenomenon that occurred in cardioplegic techniques with cardiopulmonary bypass. Therefore great effort is made to prevent reperfusion injury. Beating Heart Continuous Coronary Perfusion (BHCCP) surgery is one of the alternative techniques to improve an ischemic reperfusion injury in open-heart surgery, either in pediatric or in adult. This technique can be done in complete repair of tetralogy of Fallot (TOF). Purpose: To report our first experience in doing complete repair of TOF using beating heart technique without aortic cross-clamping Case Report: A five-year-old boy came on to ER on January 6th, 2012, with a history of cyanotic since birth. His echocardiography and catheterization concluded a tetralogy of Fallot with a McGoon ratio of 1.95 (the diameter of RPA and LPA were 9.14 mm and 8.79 mm, respectively). A complete repair of TOF was done using beating heart surgery without aortic cross-clamping technique. One month post-surgery evaluation, there weren't any neurological or motor disorders. Echocardiography results showed no residual pulmonary stenosis, but 0.2 mm residual VSD was found. Conclusion: This heart rate technique is an alternative method of myocardial protection in cardiac surgery. In several cardiac centres globally, this technique is relatively safe and can be used during surgery, especially in the total correction of TOF.
Co-Authors Abed Nego Okthara Sebayang Agus Subagjo Ahmed Eliaan Shaker Abuajwa Ansyori, Maz Isa Arief Rakhman Hakim Arifoel Hajat Chronica Elsa Retta Lumban Tobing Danang Himawan Limanto Dharmadjati, Budi Baktijasa Dhihintia Jiwangga Suta Winarno Dhihintia Jiwangga Suta Winarno Erdyanto Akbar Fhahira Rizkhika Admadiani Gerardo AK Laksono Hartono Kahar, Hartono Heri Suroto Hermina Novida, Hermina Hildegardis Dyna Dumilah I Gusti Agung Made Adnyanya Putra I Gusti Agung Made Adnyanya Putra2 Ito Puruhito Jeffrey Jeswant Dillon Jeffrey Jeswant Dillon Juliana Juliana Ketut Putu Yasa Kusworo, Afila Reza Mahrus A Rahman, Mahrus A Marsa Hendra Utomo Mochamad Wildan Paul L Tahalele Puruhito Puruhito Putranto, J.Nugroho Eko Reido Dafa Annafis Reviano, Moses Orvin Salsabila Fabianca Alsaid Sembiring, Yan Efrata Setiawan, Philia Sony Wibisono Sri Pramesthi Wisnu Bowo Negoro Sri Pramesthi Wisnu Bowo Negoro Taufiq Hidayat Taufiq Hidayat Widodo Widodo Wiwin Is Effendi