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All Journal Heart Science Journal
Kurniawan, Dea Arie
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Health Professions Immunology & microbiology Medicine & Pharmacology

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Navigating backward, healing forward: The impact of retrograde EVLT in venous ulcer management: A case report Sekarsari, Calysta Citra; Kurnianingsih, Novi; Kurniawan, Dea Arie
Heart Science Journal Vol. 6 No. 2 (2025): The Complexity in the Management of Heart Rhythm Disorder
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.02.19

Abstract

Background: Chronic venous insufficiency (CVI) is a condition caused by venous reflux (backward flow) or obstruction, leading to significant morbidity and negatively impacting patients' quality of life (QoL). One recognized treatment for CVI is Endovenous Laser Treatment (EVLT). The antegrade conventional approach of EVLT is typically straightforward, but distal vein access can sometimes be difficult to achieve. Case Illustration: A 50-year-old man presented with bilateral lower extremity swelling and a chronic ulcer on his left leg that had persisted for one year without improvement. Doppler ultrasonography confirmed CVI in both lower extremities, with a great saphenous vein (GSV) reflux time exceeding 1500 ms. The patient was diagnosed with CVI C6EpAsPr and underwent EVLT. However, the small diameter of the distal GSV and vasospasm made antegrade access challenging. A retrograde approach was employed for EVLT on his left lower extremity, resulting in a successful outcome. Conclusion: This case highlights the use of the retrograde approach in EVLT as a viable alternative for accessing distal lesions when antegrade access is difficult, leading to successful wound healing. The retrograde technique can be considered a valuable option for CVI patients facing such challenges.
Precision in practice, save the limb, save the life: Early detection of grade IIA acute limb ischemia and management using catheter-directed thrombolysis - A case report Niazta, Nisa Amnifolia; Kurnianingsih, Novi; Kurniawan, Dea Arie
Heart Science Journal Vol. 6 No. 2 (2025): The Complexity in the Management of Heart Rhythm Disorder
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.02.20

Abstract

Background: Acute limb ischemia is an emergency condition that causes high morbidity and mortality. Endovascular revascularization in acute limb ischemia showed better in-hospital clinical outcomes than surgical revascularization. Case illustration: A 67-year-old man was referred by internal medicine at the rural area hospital with a diagnosis of acute limb ischemia. He complained of sudden left leg pain and numbness of the left leg 2 days prior to hospital admission. He was a heavy smoker and had a predisposition for atrial fibrillation. He received heparinization at the previous hospital. Upon arriving at Saiful Anwar Hospital, a physical examination showed severe left leg pain and was difficult to move. His left leg was pulseless, paresthesia and poikilothermia. Duplex ultrasound revealed a thrombus in the left popliteal artery with no flow downwards. We diagnosed the patient with Acute Limb Ischemia Rutherford IIA left inferior extremity. We decided to perform catheter-directed thrombolysis with the Alteplase regiment. Post catheter-directed thrombolysis angiography evaluation showed TIMI flow II at the left leg after 24-hour catheter-directed thrombolysis. The patient did not complain of leg pain or numbness anymore. Conclusion: Good outcomes in this patient were obtained through the ability to make correct initial diagnosis, early administration of heparin, and immediate referral to a cardiovascular center that can provide endovascular treatment. Catheter-directed thrombolysis is the right choice for grade IIA acute limb ischemia
Acute Hemodynamic Index as a Predictor of In-Hospital Mortality in Mechanical Ventilated Acute Decompensated Heart Failure Patients Kurniawan, Dea Arie; Anjarwani, Setyasih; Rizal, Ardian; Satrijo, Budi; Yogibuana, Valerinna
Heart Science Journal Vol. 4 No. 1 (2023): Optimizing Outcome in Acute Cardiac Care
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.01.4

Abstract

Background: The likelihood of a poor clinical outcome is significantly increased in patients with acute decompensated heart failure. Mechanical ventilation was necessary for 23% of ADHF patients receiving treatment. The simple parameters of blood pressure and heart rate have good accuracy and repeatability. The development of the Acute Hemodynamic Index allowed for the calculation of pulse pressure and heart rate to be used as a basis for predicting intrahospital mortality.Methods: The medical records of patients who received care at CVCU RSSA were used in this retrospective, single-center study. ROC analysis and multivariate regression analysis were used to evaluate the prognostic performance of AHI. Statistical significance was determined by the P value of 0.05 or lower.Results: 252 patients with heart failure and low ejection fraction had their data analyzed. Hospital mortality is 82 percent. The cut-off was 4.19 mmHg/bpm, which was the AHI value. 68.8% of patients with fatal illnesses had low AHIs ( 4.19 mmHgbpm). AHI > 4.19 mmHgbpm patients have a 9-fold increased risk of dying in the hospital than patients with low AHI. AUC: 0.825 [0.743-0.907]; sensitivity: 0.814; specificity: 0.689; AUC: 0.825 [0.743-0.907; p = 0.000]; demonstrate the high predictive power of AHI.Conclusion: AHI has a strong degree of association with the likelihood of dying in the hospital from acute decompensated heart failure.
Co-Authors Anjarwani, Setyasih Kurnianingsih, Novi Niazta, Nisa Amnifolia Rizal, Ardian Satrijo, Budi Sekarsari, Calysta Citra Yogibuana, Valerinna