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All Journal Sari Pediatri Qanun Medika - Medical Journal Faculty of Medicine Muhammadiyah Surabaya Jurnal Respirasi (JR) JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Majalah Biomorfologi (Biomorphology Journal) Heart Science Journal CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL Indian Journal of Forensic Medicine & Toxicology JKKI : Jurnal Kedokteran dan Kesehatan Indonesia Journal of Indonesia Vascular Access Jurnal Widya Medika Folia Medica Indonesiana
Sembiring, Yan Efrata
Department Of Cardiothoracic And Vascular Surgery, Faculty Of Medicine, Universitas Airlangga/ Dr. Soetomo General Academic Hospital, Surabaya
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Left Anterior Descendent Coronary Artery Fistula to Main Pulmonary Artery with Triple Vessel Disease:A Report of Two Cases Lyndon Darwin; Yan Efrata Sembiring; Oky Revianto Sediono Pribadi
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 3 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i3.15837

Abstract

Coronary artery fistula is a rare anomaly of coronary artery. It represents connection between one or more ofcoronary arteries and cardiac chamber or great vessel. It can also cause significant hemodynamic changes. Toreport cases of left anterior descending coronary artery (LAD) fistula to main pulmonary artery (MPA) withconcomitant triple vessel disease.Case 1 was 59-year old male presented with intermittent chest discomfortfor a year. Echocardiogram showed severe MR with cleft at A1 and A2 and coronary angiogram resultshowed LAD fistulation to MPA. Case 2 was 57-year old male presented with chest discomfort and at the leftshoulder. Echocardiogram showed trivial MR and coronary angiogram showed triple vessel disease alongwith tortuous fistulation of LAD to MPA. Both patients underwent teflonpledget-reinforced direct suturingof fistula origin and 3-grafts coronary artery bypass graft. Patient no 1 also underwent mitral annuloplastyand valvuloplasty.Post-operative period was uneventful and both patients were discharged after 17 days and5 days respectively. Short term follow-up showed improvement of symptoms and no residual fistulation.Inshort term follow-up teflonpledget-reinforced direct suturing of coronary fistula origin result satisfactory.Larger study and further follow up is necessary.
Multiple Large Atrial Thrombus Due To Rheumatic Heart Disease And Present Of Atrial Fibrillation With No Sign Of Stroke: How Is It Possible? Ricky Indra Alfaray; Deisha Laksmitha Ayomi; Yan Efrata Sembiring
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 3, No 2 (2019)
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (625.712 KB) | DOI: 10.30651/jqm.v3i2.2327

Abstract

ABSTRACT  Atrial fibrillation is the most common arrhythmia associated with stroke and in the rheumatic heart disease patient’s atrial fibrillation can easily cause thromboembolism. Thromboembolism is the major complication also in patients of mitral stenosis with atrial fibrillation. A 54-year-old woman with uncontrollable movements in the right arm, stomach, right leg and painful swelling at right ankle joint was admitted to the emergency department. Transesophageal echocardiogram revealed rheumatic heart disease affecting two valves and thrombus in left atrial extending towards left atrial appendage. Heart rate was 120 beats per minute. ECG showed atrial fibrillation. A patient has undergone mitral and aortic valves replacement surgery and left atrial thrombus evacuation. Despite the involvement of two heart valves and the presence of large thrombus, the patient did not show any sign of brain infarction. This is a contradiction with a theory which implies that atrial fibrillation is the most common arrhythmia associated with stroke and in the rheumatic heart disease patient’s atrial fibrillation can easily cause thromboembolism and become stroke. This study evaluates many factors founded in the patient that make this anomaly may happen.Keywords                   : atrial fibrillation, rheumatic heart disease, thromboembolism strokeCorrespondence to      : rickyindraalfaray@gmail.comABSTRAK Atrial fibrilasi merupakan jenis aritmia yang berkaitan erat dengan stroke dan cenderung menyebabkan thromboembolism. Thromboembolism merupakan komplikasi mayor dari mitral stenosis dengan atrial fibrilasi. Seorang wanita berusia 54 tahun masuk ke unit gawat darurat dengan keluhan utama gerakan tak terkendali pada lengan kanan, perut, kaki kanan, serta bengkak yang menyakitkan di sendi pergelangan kaki kanan. Echocardiogram transesophageal menunjukan gambaran penyakit jantung rematik pada dua katup dan trombus di atrium kiri meluas menuju valve atrium kiri. Detak jantung 120 kali per menit. EKG menunjukkan fibrilasi atrium. Pasien menjalani operasi penggantian katup mitral dan aorta serta evakuasi trombus pada atrium. Meskipun terdapat abnormalitas pada dua katup jantung ditambah dengan ditemukan adanya trombus besar pada atrium, pasien tidak menunjukkan tanda-tanda infark otak. Ini bertentangan dengan teori yang mengimplikasikan bahwa atrial fibrilasi adalah aritmia paling umum yang berhubungan dengan stroke dan pada penyakit jantung reumatik. Pasien dengan fibrilasi atrium dapat dengan mudah terjadi tromboemboli hingga bermanifestasi stroke. Studi ini mengevaluasi berbagai faktor yang memungkinkan anomali kasus seperti ini dapat terjadi.Kata kunci                  : fibrilasi atrium, penyakit jantung rematik, stroke thromboemboliKorespondensi             : rickyindraalfaray@gmail.com 
Faktor Risiko Pneumonia pada Anak dengan Penyakit Jantung Bawaan Tia Harelina; Retno Asih Setyoningrum; Yan Efrata Sembiring
Sari Pediatri Vol 21, No 5 (2020)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp21.5.2020.276-81

Abstract

Latar belakang. Penyakit jantung bawaan (PJB) merupakan faktor risiko utama yang memperparah infeksi saluran pernapasan bawah akut. Infeksi saluran pernapasan bawah akut yang paling umum adalah pneumonia. Beberapa faktor predisposisi untuk pneumonia telah diidentifikasi, seperti pada malnutrisi berat.Tujuan. Untuk mengetahui faktor risiko kejadian pneumonia anak dengan penyakit jantung bawaan di RSUD Dr.Soetomo Surabaya.Metode. Jenis penelitian ini adalah analitik observasional dengan desain kasus kontrol berdasarkan data rekam medik pasien yang dirawat di Ruang Rawat Inap SMF Ilmu Kesehatan Anak RSUD Dr. Soetomo Surabaya selama periode Januari 2016 sampai dengan Desember 2016. Analisis data dilakukan dengan uji chi-square dan regresi logistik. Kriteria inklusi untuk kelompok kasus adalah pasien PJB dengan pneumonia, sedangkan kelompok kontrol pasien PJB tanpa pneumonia dengan umur 1 bulan sampai 60 bulan. Kriteria eksklusi adalah rekam medik yang tidak lengkap.Hasil. Diperoleh subjek sebesar 66 pasien, dengan perbandingan kasus-kontrol 1:1. Hasil analisis multivariat ditemukan adanya hubungan yang signifikan antara anemia dengan kejadian pneumonia pada anak dengan PJB (p=0,002) dan terdapat hubungan yang signifikan antara neuromuscular disease dengan kejadian pneumonia pada anak dengan PJB (p=0,015).Kesimpulan. Adanya hubungan antara anemia dan neuromuscular disease dengan pneumonia pada anak dengan penyakit jantung bawaaan.
Percutaneous retrieval of intracardiac fragmented hemodialysis catheter using a snare-loop catheter: A case report Adhitya Ginting; Ketut Putu Yasa; Yan Efrata Sembiring
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 11, No 2, (2020)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol11.Iss2.art14

Abstract

We presented a 60-year-old woman with an history of end-stage renal disease on regular hemodialysis, twice a week, came with a tunneled dialysis catheter (TDC) that was attached to the right internal jugular vein. TDC has been dysfunction since one week ago that was suspected as a result of thrombosis in the lumen of TDC. TDC was cut in the insertion of the jugular vein. And then a wire was inserted into TDC that has been cut off. From Chest x-ray imaging, migration of fragmented TDC was found inside the heart chamber with wire inside the lumen. Fluoroscopy showed a picture of a fragmented TDC in the heart chamber with a wire inside the lumen. Retrieval of fragmented TDC used percutaneus snare loop method with wire guiding that was inserted through the left femoral vein. Fragmented TDC was removed successfully. Retrieval of the fragmented TDC through endovascular techniques is classified as a simple. Simple snare loop method is quite effective and very cheap compared to the commercial snare, open surgery or laparoscopic surgery that can be avoided.
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.
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.
Success Rate of Coronary Artery Bypass Grafting on Elderly Patients in Dr. Soetomo General Academic Hospital, Surabaya Tombokan, Amelia Mathilda; Sembiring, Yan Efrata; Dharmadjati, Budi Baktijasa; Pribadi, Oky Revianto Sediono
JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Vol. 15 No. 1 (2024): Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/juxta.V15I12024.1-7

Abstract

Highlights: CABG is the most performed cardiac surgery in Indonesia, and most patients undergoing this surgery are above 60 years old. CABG success rate is not significantly influenced solely by the patient's age but also by several perioperative characteristics such as gender, comorbidities, and other variables included in the calculation of EuroSCORE II.   Abstract Introduction: Coronary artery disease (CAD) has caused more than a quarter of deaths in Indonesia and is found to be more prevalent in elderlies (≥60 years old). Treatment options include coronary artery bypass grafting (CABG), the most-performed cardiac surgery in Indonesia. This study aimed to determine the short-term and one-year postoperative success, morbidity, and mortality rates with their causes in Dr. Soetomo General Academic Hospital, Surabaya. Methods: This was a cross-sectional retrospective study using secondary data obtained from 85 medical records of CABG patients aged ≥60 years old in the Department of Thoracic, Cardiac, and Vascular Surgery Dr. Soetomo General Academic Hospital, Surabaya, from January 2018 to December 2020. Aside from descriptive statistics, logistic regression was conducted to assess the relationship between EuroSCORE II and the success of CABG in elderly patients. A probability (p) value < 0.05 was considered significant. Results: Patients were mostly male in their sixties with a mean of 65.5 ± 4.9 years old, had three-vessel disease, and predicted mortality of 1.6%. The average number of grafts used was 3.3 ± 0.7, and the average length of hospital stay was 7.4 ± 2.4 days. The morbidity rate was 71.8%, with bleeding as the most common complication, a 17.6% mortality rate, and a success rate of 82.4% (short-term) and 80% (one-year postoperative). Higher EuroSCORE II was found to significantly decrease the probability of both short-term (prevalence ratio [PR], 0.766; 95% CI, 0.604-0.971; p = .028) and one-year postoperative success (PR, 0.787; 95% CI, 0.624-0.993; p = .044). Conclusion: Surgical success in elderly patients is influenced by many factors, and old age should not deter physicians from referring patients for CABG. Despite the ability of EuroSCORE II to predict surgical success, both short-term and one-year survival, on elderly patients, there is a need for holistic and locally validated scoring systems to both evaluate and predict surgical success due to the unique healthcare context of Indonesia.
Navigating Complex Cardiovascular Pathologies: A Case Report on Aortic Arch Replacement in a Middle-Aged Male with Stanford A DeBakey I Aortic Dissection Handari, Saskia Dyah; Firdaus, Muhammad; Sembiring, Yan Efrata
Heart Science Journal Vol. 5 No. 2 (2024): Challenges in the Management of Congenital Heart and Structural Heart Diseases
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.02.14

Abstract

Background: Aorta dissection is characterized by the presence of an intimal tear, which permits the passage of blood through the tear and into the aorta media. This process leads to the separation of the intimal and the formation of a dissection flap, representing the true lumen and a newly formed false lumens. The incidence of aortic dissection varies between 0.2% and 0.8%. Management of acute aortic standford A aortic dissection primarily involves invasive surgical procedures.Case presentation: A middle-aged male patient, aged 40, who possesses risk factors including uncontrolled hypertension and obesity, arrived to the emergency room with symptoms of chest pain. He described the pain as tearing in nature and said that it radiated towards the abdominal. The examination findings included a blood pressure reading of 255/143, a widened mediastinum and cardiomegaly observed on the chest X-ray, a slight elevation in Hs-Troponin levels, and the presence of sinus rhythm with left ventricular hypertrophy. He underwent CT scan, which demonstrated the presence of an aortic dissection extending from the ascending to descending aorta, with no associated damage to the aortic valve from echocardiography. He was diagnosed with Standford A DeBakey I Aortic dissection and underwent preference replacement of the aortic arch and elephant trunk implantation instead of Bentall procedure.Conclusion: The surgical and perioperative methods employed may differ based on the specific clinical presentation and the nature of the aortic disease. Because there was no involvement of the aortic valve, we performed total aortic arch replacement and elephant trunk procedure over the Bentall procedure.
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.
When Do We Need Pleural Surgery? Paul L Tahalele; Merlinda Dwintasari; Y Motulo; Yan Efrata Sembiring; Dhihintia Jiwangga Suta
JURNAL WIDYA MEDIKA Vol. 5 No. 2 (2019)
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33508/jwm.v5i2.2200

Abstract

Pleural sac is an enclosed sac covering the lung that consist of two membranes, i.e. parietal and visceral pleura. It has a cavity filled with small amount fluid that plays important role to provide smooth sliding of lung during respiration. Change or disturbance in the pleural cavity and or the pleura itself may result in restriction of lung expansion causing ventilation compromise. Pathology of pleura may result from varying etiology. It may present as inflammatory pleural effusion, non-inflammatory pleural effusion, pneumothorax, hematothorax, fibrothorax, pleural tumors, and cylothorax. Diagnostic tool for pleural diseases may be made from the simplest chest x-ray, ultrasound, computed tomography, MRI and histopathological studies. There are several treatment options for managing pleural diseases. It consist non operatif treatment, pleural drainage, decortication or pleurectomy, pleurodesis, and/ or resection of pleural tumor through procedure VATS, or open thoracotomy. Indications for surgery are traumatic or spontaneous pneumothorax, hematothorax, cylothorax, failure of non operatif treatment, fibrothorax or schwarte limiting lung expansion, mesothelioma, and recurrent pneumothorax or malignant pleural effusion. Decision for surgery need appropriate timing and planning regarding different pathology and different etiology.
Co-Authors Abed Nego Okthara Sebayang Adhitya Ginting Agung Dwi Wahyu Widodo Ahmed Eliaan Shaker Abuajwa ALVERINA, CLARA Danang Himawan Limanto Deisha Laksmitha Ayomi Dharmadjati, Budi Baktijasa Dhihintia Jiwangga Suta Dhihintia Jiwangga Suta Dhihintia Jiwangga Suta Winarno Dhihintia Jiwangga Suta Winarno Dillon, Jeffrey Jeswant Hakim, Arief Rakhman Hermina Novida, Hermina I Gusti Agung Made Adnyanya Putra I Gusti Agung Made Adnyanya Putra2 Indra Alfaray, Ricky Ito Puruhito Jeffrey Jeswant Dillon Jeffrey Jeswant Dillon Juliana Juliana Juliana Juliana Ketut Putu Yasa Ketut Putu Yasa Lyndon Darwin Mahrus A Rahman, Mahrus A Merlinda Dwintasari Merlinda Dwintasari Muhammad Firdaus Negoro, Sri Pramesthi Wisnu Bowo Oky Revianto Sediono Pribadi Paul L Tahalele Pribadi, Oky Revianto Sediono Puruhito Puruhito Puruhito Puruhito, Ito Putra, I Gusti Agung Made Adnyana Putra2, I Gusti Agung Made Adnyanya Rahman, Mahrus Abdur Retno Asih Setyoningrum Reviano, Moses Orvin Rizki, Mohamad Saskia Dyah Handari Soebroto, Heroe Soebroto, Heroe Sri Pramesthi Wisnu Bowo Negoro Sri Pramesthi Wisnu Bowo Negoro Tia Harelina Tombokan, Amelia Mathilda Utamayasa, I Ketut Alit Widodo Widodo William, Andrew Winarno, Dhihintia Jiwangga Suta Wiwin Is Effendi Y Motulo Y Motulo