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All Journal Jurnal Anestesiologi Indonesia Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Jurnal Anestesi Perioperatif The Indonesian Journal of Public Health Indonesian Journal of Anesthesiology and Reanimation (IJAR) Jurnal Anestesi Obstetri Indonesia Jurnal Kesehatan Tambusai Solo Journal of Anesthesi, Pain and Critical Care Journal of Anesthesiology and Clinical Research Majalah Anestesia & Critical Care (MACC) Jurnal Komplikasi Anestesi
Juni Kurniawaty Muhdar Abubakar Djayanti Sari
Departemen Anestesiologi Dan Terapi Intensif, Fakultas Kedokteran, Kesehatan Masyarakat Dan Keperawatan, Universitas Gadjah Mada, Yogyakarta|Universitas Gadjah Mada
Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Dentistry Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Anesthetic Management for Atrial Septal Defect Closure in a Patient with Bidirectional Shunt and Pulmonary Hypertension Hapsari, Paramita Putri; Kurniawaty, Juni
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 4, No 1 (2024): April 2024
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v4i1.82249

Abstract

Background : ASD bidirectional shunt occurs when flow moves between left and right depending on the higher pressure, either systemic vascular resistance (SVR) or pulmonary vascular resistance (PVR). The anesthetic management aimed to maintain the left-to-right shunt and control factors that could increase PVR while retaining SVR within normal or slightly elevated ranges.Case Illustration : We reported a 39-year-old female patient with ASD, bidirectional shunt, and pulmonary hypertension (PH) who underwent defect closure. Due to the mean pulmonary pressure exceeded 50% of mean systemic pressure, an intentional ASD creation was performed. It is not a routine procedure; however, it serves as a “way out” if there is severe left ventricular dysfunction. Attention and intervention were promptly administered for any identified post-surgical issues, including PH crisis or right ventricular dysfunction. The management of PH was conducted during perioperative period and the patient was successfully extubated at 17 hours post-surgery.Conclusion : Perioperative management of bidirectional shun ASD with PH requires a SVR and PVR. Factors that can increase PVR must be avoided/controlled and on the other hand SVR must be maintained.
Co-Authors Akhmad Yun Jufan Alqustar, Adam Ancilla, Cornelia Anindita, Mohammad Pradhana Baskoro, Ronggo BHIMO PRIAMBODO Bhirowo Yudo Pratomo Bowo Adiyanto Budi Yuli Setianto Calcarina Fitriani Retno Wisudarti Cindy Elfira Boom Daniswara Deviatika, Fiandila Elvana Dewi, Baiq Dessy Resmana Djayanti Sari Fadinie, Wulan Fatmi Eka Putri Gentong, Metia Gledis Gilang Hapsari, Paramita Putri Hartiah Haroen Herdono Poernomo Hermawan, Hendra Joni, Rendy Pranda Khoeri, Fatkhur Roofi Kurniaji Kurniaji Kusuma, Danur Adi Kusumandaru , Novierta Prima Meta Restu Synthana Muhammad Mufti Sofyanoor Muhdar Abubakar Novita Intan Arovah Nurdiansyah, Elba Oktavian Rizki Ilahi Pambudi, Estu Agung Parna, Dian Raseka Prandani, Muhammad Yogi R W, Calcarina Fitriani Rani, Hajar Rafika Ratih Kumala Fajar Apsari Rayhandika Ridha, Ihsanur Rifdhani Fakhrudin Nur Rifdhani Fakhrudin Nur Sadewo, Yuri Sari, Dhanty Dwita SATRIYAS ILYAS Setiandari, Kristina Sofwan, Fachruddin Stanie, Shianita Sudadi Supomo Supomo Utomo, F uad Cipto Wardhana, Ardyan Wardhana, Ardyan Prima Wibowo, Erry Alamsyah Asjhuri yudihart, Subhan Yunita Widyastuti Yusmein Uyun