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All Journal Indonesian Journal of Cardiology
Amir Aziz Alkatiri
Faculty of Medicine, University of Indonesia/ Harapan Kita National Cardiovascular Center
Health Professions Medicine & Pharmacology

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Factors Influencing Mortality of Thoracic Aortic Surgery in The Third World Country Diansari, Rienna; Aligheri, Dicky; Herlambang, Bagus; Wicaksono, Sony Hilal; Mendel, Brian; Yaniarti, Dian; Alkatiri, Amir Aziz; Andriantoro, Hananto; Adiarto, Suko
Jurnal Kardiologi Indonesia Vol 44 No 2 (2023): Indonesian Journal of Cardiology: April - June 2023
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1494

Abstract

Background: A prominent increase of overall global death rate of aortic disease is seen on developing country, with South-east Asia having the highest increase of 41%. Lack of identification and prompt management of the diseases in conjunction with lack of facilities in third world countries that could perform aortic surgery made the procedure more complex when the patients admitted to tertiary hospitals Methods: The data was obtained through medical record of patients underwent thoracic aortic surgery from 2018 to 2021 in National Cardiovascular Center Harapan Kita (NCCHK). One-year and 3-year survival analysis was obtained through phone calls and digital messages. Statistical analysis was done to investigate the impact of surgical complexity as the main predictor and other variables on primary (in-hospital mortality) and secondary (mid-term survival) outcome. Results: A total of 208 patients were included in the analysis; 157 (75,5%) underwent complex surgery, and 51 (24,5%) underwent non-complex surgery. In-hospital mortality was similar across 2 groups (23,6% vs 13,7%; p = 0,1240). On multivariable analysis, malperfusion syndrome (OR 3,560; p = 0,002), CPB duration > 180 minutes (OR 4,331; p = 0,001), and surgical priority (urgent OR 4,196; p = 0,003; emergency OR 10,879; p = 0,001) were identified as independent predictor of in-hospital mortality. Cox regression identified diabetes (HR 4,539; p = 0,025) and emergency procedure (HR 9,561; p = 0,015) as independent predictors for 1-year mortality, and diabetes (HR 3,609; p = 0,004), aortic dissection (HR 2,795; p = 0,029), and maximum aortic diameter (HR 1,034; p = 0,003) for 3-year mortality. Surgical complexity was not associated with early and mid-term mortality. Conclusions: In patients undergoing thoracic aortic surgery, surgical complexity was not associated with early and mid-term survival. Early and mid-term survival was largely determined by patient comorbidities and intra-surgery factors.This article has a related Erratum.
Invasive Physiologic Study Across Various Spectrum of Coronary Artery Fistulas with Concomitant Coronary Artery Stenosis Sembiring, Theresia Sri Rezeki; Mangkuanom, Arwin Saleh; Firman, Doni; Alkatiri, Amir Aziz; Iryuza, Nanda
Jurnal Kardiologi Indonesia Vol 45 No 1 (2024): January - March, 2024
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1285

Abstract

Background: Most CAFs are asymptomatic but it might have serious hemodynamic consequences causing signs and symptoms of myocardial ischemia and heart failure prompting intervention, be it percutaneous or surgical, to manage the hemodynamic burden. Currently, there’s no widely accepted guidelines or consensus to manage patients with CAFs. The decision to undergo intervention is usually based on the presence of symptoms, size and also the anatomic features of the fistula. Case Illustration and Discussion: We presented 5 patients with CAFs undergoing FFR/iFR in our institution. Of all patients, only one showed significant iFR suggesting significant hemodynamic burden, probably due to stealing phenomenon. Number of fistulas varied from 1 – 3 with most fistula arose from left anterior descending and terminated in pulmonary artery. Only one patient underwent RHC showing relatively normal flow ratio supported by normal iFR reading across different coronary artery segments. One patient presented with patent stents in LAD and OM2 despite existing subtotal occlusion in proximal PDA, the other one presented with insignificant stenosis in RCA, and the other two presented with no concomitant stenosis. We underwent no further intervention for 4 patients with normal FFR/iFR reading but we underwent stent implantation for one patient with significant FFR/iFR reading. Upon 1-year-follow up, all patients are currently doing well with no significant complaints of chest pain or dyspnea. Conclusion: Due to limited literature covering the issue of CAFs and coronary artery stenosis, the decision which to intervene first between these two is currently still in the discretion of the attending physician. Whenever possible, further diagnostic work up should always be performed as an objective parameter of hemodynamic burden. FFR/iFR might be considered as one of many modalities to do so. Yet, further well-designed studies are needed to confirm the role of FFR/iFR hoping this modality might someday help in guiding decision-making in patients with CAFs. Keywords: coronary artery fistula; coronary artery stenosis; free fractional reserve (FFR); instantaneous wave free ratio (iFR)
Does Chronic Inflammation Play a Role in Rheumatic Mitral Valve Restenosis after Percutaneous Transvenous Mitral Commissurotomy? Butarbutar, Maruli; Soesanto, Amiliana M.; Firman, Doni; Ariani, Rina; Alkatiri, Amir Aziz; Wicaksono, Sony Hilal
Jurnal Kardiologi Indonesia Vol 43 No 3 (2022): Indonesian Journal of Cardiology: July - September 2022
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1398

Abstract

Background: Mitral valve restenosis is defined as decreased mitral valve area (MVA) <1.5 cm2 or decreased MVA >50% after PTMC. It is time-dependent and associated with major adverse cardiovascular events (MACE), such as congestive heart failure, cardiac death, mitral valve replacement, and redo PTMC. The mechanism is not yet known; however, chronic inflammation may have a role. This research aims to determine the association between chronic inflammation and mitral valve restenosis after PTMC. Methods: A total of 40 patients with mitral valve stenosis who underwent successful PTMC were matched and classified into restenosis/case group (n=20) and no restenosis/control group (n=20). Secondary data was taken from electronic medical records such as patient characteristics (gender, age & 2nd prophylaxis), echocardiography data before PTMC (Wilkins’ score and MVA before PTMC), and echocardiography data after PTMC (MVA after PTMC). Follow-up echocardiography examination (follow-up MVA) and laboratory assessment of chronic inflammation marker (IL-6) were done on all patients. Statistical analyses were done to look for an association between the level of chronic inflammation marker & other independent variables with mitral valve restenosis. Results: Median IL-6 concentration was 2.39 (0.03 – 11.4) pg/mL. There was no statistically significant difference in IL-6 levels between both groups (p-value >0.05). MVA decrement was 0.13 (0 – 0.62) cm2/year with rate of MVA decrement ≥0.155 cm2/year was predictor of mitral valve restenosis (p-value <0.001, OR = 46.72, 95% CI 6.69 – 326.19). Conclusion: Chronic inflammation assessed by IL-6 was not associated with mitral valve restenosis.This article has a related Erratum.
Factors Influencing Mortality of Thoracic Aortic Surgery in The Third World Country Diansari, Rienna; Aligheri, Dicky; Herlambang, Bagus; Wicaksono, Sony Hilal; Mendel, Brian; Yaniarti, Dian; Alkatiri, Amir Aziz; Andriantoro, Hananto; Adiarto, Suko
Jurnal Kardiologi Indonesia Vol 46 No 4 (2025): October - December, 2025
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.2001

Abstract

In “Factors Influencing Mortality of Thoracic Aortic Surgery in the Third World Country” (Indonesian Journal of Cardiology, 44(2), 41-52. https://doi.org/10.30701/ijc.1494), there are several errors noted.An error has been found in the PDF version of this article. The DOI printed in the PDF is incorrect. The correct DOI is https://doi.org/10.30701/ijc.1494. The error occurs only in the PDF; the DOI listed in the article metadata is already correct.An error also appears in the affiliations section. In the original article, the affiliation for author Brian Mendel was incorrectly displayed as “Department of Cardiology & Vascular Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia”. The affiliation has been corrected to “Sultan Sulaiman Government Hospital, Serdang Bedagai, Sei Rampah, Indonesia”.The publisher apologizes for any inconvenience caused by this error.DOI of original article: https://doi.org/10.30701/ijc.1494
Does Chronic Inflammation Play a Role in Rheumatic Mitral Valve Restenosis after Percutaneous Transvenous Mitral Commissurotomy? Butarbutar, Maruli; Soesanto, Amiliana M; Firman, Doni; Ariani, Rina; Alkatiri, Amir Aziz; Wicaksono, Sony Hilal
Jurnal Kardiologi Indonesia Vol 46 No 4 (2025): October - December, 2025
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.2002

Abstract

In “Does Chronic Inflammation Play a Role in Rheumatic Mitral Valve Restenosis after Percutaneous Transvenous Mitral Commissurotomy?” (Indonesian Journal of Cardiology, 43(3), 101-107. https://doi. org/10.30701/ijc.1398), there is an error noted. An error has been found in the PDF version of this article. The DOI printed in the PDF is incorrect. The correct DOI is https://doi.org/10.30701/ijc.1398. The error occurs only in the PDF; the DOI listed in the article metadata is already correct. The publisher apologizes for any inconvenience caused by this error. DOI of original article: https://doi.org/10.30701/ijc.1398
Co-Authors Aligheri, Dicky Amiliana M Soesanto Amiliana M. Soesanto Ariani, Rina Bagus Herlambang Butarbutar, Maruli Diansari, Rienna Doni Firman Hananto Andriantoro Iryuza, Nanda Mangkuanom, Arwin Saleh Mendel, Brian Sembiring, Theresia Sri Rezeki Suko Adiarto Wicaksono, Sony Hilal Yaniarti, Dian