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All Journal JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Cardiovascular and Cardiometabolic Journal (CCJ) JKKI : Jurnal Kedokteran dan Kesehatan Indonesia Journal of Indonesia Vascular Access
Danang Himawan Limanto
Department Of Cardiothoracic And Vascular Surgery, Faculty Of Medicine Universitas Airlangga, Airlangga University Hospital, Surabaya, Indonesia
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Thoracic ectopia cordis: A case report Danang Himawan Limanto; Heroe Soebroto
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 11, No 1, (2020)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol11.Iss1.art15

Abstract

Ectopia Cordis is a congenital anomaly in which the heart is located abnormally outside the thoracic cavity. Aetiology of this defect is still unclear with the incidence rate of 8:1,000,000 live births. Clinical manifestations usually present as severe sepsis respiratory distress due to heart failure as a result of an intrinsic abnormality of the heart which makes the management more challenging. Five days-old female newborn was referred to our hospital by a local doctor with “beating lump” outside her chest. The diagnosis of complete thoracic ectopia cordis was made by clinical examination, chest x-ray, and echocardiography. The Echo showed complete AV canal, ASD, mild pulmonary stenosis, and atrioventricular valve regurgitation. Palliative surgery was then undertaken with the initial goal to limit exposure and prevent further infection. The heart is covered with bovine pericardium sutured along the edge of the chest wall defect. Ectopia cordis is rare and has a poor prognosis especially thoracic and cervical types. Definitive surgery, to replace the heart to the thoracic cavity, is difficult to perform because of the hypoplastic thoracic cavity. Attempt to do palliative surgery, such as covering the heart with either skin flap or other material, becomes the choice of treatment in this case although there is no evidence reported of adulthood survivors.
Iatrogenic pseudoaneurysm as a complication of hemodialysis vascular access: a descriptive study Ni Kadek Sulistyaningsih; Zanella Yolanda Lie; Danang Himawan Limanto
Journal of Indonesia Vascular Access Vol. 2 No. 2 (2022): (Available Online: December 2022)
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v2i2.23

Abstract

Introduction: Iatrogenic pseudoaneurysm (PSA) in hemodialysis vascular access puncture site is the most common complication in a patient with ERSD, which needs urgent surgical intervention. This research explained the patients’ characteristics with pseudoaneurysm in vascular access that underwent surgical intervention immediately. Methods: Retrospectively, it reported cases of pseudoaneurysm that underwent immediate surgical intervention in an operating theatre in the emergency department of RS Dr. Soetomo Surabaya. Result: Twenty-one patients, whose age range from 26-to 64 years old (mean 46.57 + 12.14 years), have undergone immediate surgical and vascular intervention in an operating theater in the emergency department of RS Dr. Soetomo from 2017 until March 2021. The site of pseudoaneurysm varies from cubiti (90.4%), with signs and symptoms of impending rupture (57.1%), rupture (28.6%), and infected pseudoaneurysm (14.3%). Surgical management such as arterial repair was conducted in 90.4% of cases, and two patients (9.6%) unfortunately underwent takedown AVF. It was found from all 21 cases that nine cases didn’t have vascular access as recommended, leading to repetitive puncture in the same puncture site. Conclusion: Iatrogenic Pseudoaneurysm in ESRD patients on regular hemodialysis is the most common complication that has been treated. The medical staff’s knowledge about recognition and prevention is a crucial factor in controlling this complication
Angioplasty experience for central venous stenosis in hemodialysis patients: a case series Nyoman Saka Ranuartha; Danang Himawan Limanto; Ketut Putu Yasa
Journal of Indonesia Vascular Access Vol. 3 No. 1 (2023): (Available Online: June 2023)
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v3i1.33

Abstract

Objective: To report the treatment of central venous stenosis in hemodialysis patients with endovascular intervention angioplasty. Introduction: Central venous stenosis is a common case in patients with renal failure or end-stage renal disease who have a history of dialysis, which requires vascular access. The currently available techniques for managing central venous stenosis are endovascular intervention with angioplasty and stent placement. Although open surgical treatment has shown durability in the past, it was correlated with significant morbidity. One of the techniques describes the antegrade technique of endovascular intervention. Case description: In this study present 5 cases of central venous stenosis in patients with hemodialysis. In this case series, the patient complained that had a history of swelling in the upper arm unilateral. Diagnostic with catheterization, there was stenosis of the subclavian vein and innominate. This study performed the endovascular management experience with the preferred treatment for central venous stenosis to perform revascularization procedures which is percutaneous transluminal angioplasty (PTA) with balloon angioplasty. Conclusions: Management of central venous stenosis in patients with hemodialysis can be presented effectively and safely using angioplasty which results in low rates of complication and usually has a shorter length of stay post-procedural.
Correlation Between Cardiopulmonary Bypass Time (CPB Time) during Coronary Artery Bypass Graft on ICU Length of Stay Andreas Rama Arkananta Nugraha; Danang Himawan Limanto; Philia Setiawan; Atika
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.v5i1.2024.1-10

Abstract

Highlight: 1. CHD remains one of the most threatening CVD in Indonesia. Studies discussing CHD will contribute in future studies for cardiologists to assert better options for treatment. - Abstract Background: Coronary heart disease (CHD) is one of the deadliest diseases in Indonesia. Coronary artery bypass graft using cardiopulmonary bypass (CPB) is an integral measure in its treatment. The objective of this study is to identify the correlation of CPB Time and Length of Stay (LOS) in the Intensive Care Unit (ICU) in Dr.Soetomo General Academic Hospital, Surabaya. Material and Methods: This study was conducted using observational and analytic methods. The population are coronary heart disease patients who underwent coronary artery bypass graft. A total sampling method was used from the medical records of Dr. Soetomo General Academic Hospital, Surabaya from October 2021 until September 2022. The research variables are: CPB time and ICU LOS. The relationship between CPB and ICU LOS was analyzed using the Spearman correlation test and logistic regression as well Mann-Whitney test using Microsoft Excel and SPSS version 25. Results: From the results of the correlation test, there is no correlation between CPB Time and ICU LOS with a correlation coefficient of r=0212, there is no significant difference between CPB ≤180 minutes and CPB >180 minutes on ICU LOS p=0.123.  From  the  overall  sample,  the  average  age  was  62.24+7.765  years,  with the majority of the sample were male  87.3%. Conclusion: There is no correlation between the CPB Time and ICU LOS in patients after coronary artery bypass graft at RSUD Dr. Soetomo.
Type 2 Diabetes Mellitus Status with Ankle-Brachial Index among Patients with Diabetic Foot Ulcer at Universitas Airlangga Hospital, Surabaya Anisah, Hana; Limanto, Danang Himawan; Suryantoro, Satriyo Dwi; Utomo, Budi; Permana, Putu Bagus Dharma
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.V15I12024.51-56

Abstract

Highlights: ABI was not influenced by diabetic status due to potential confounders. A more severe form of diabetic ulcer was associated with a lower ABI value.   Abstract Introduction: Diabetic foot ulcer (DFU) is one of the most significant complications of uncontrolled type 2 diabetes mellitus (T2DM) that may affect a patient's prognosis and quality of life. This study aimed to identify the association between diabetic status, DFU severity, and other clinical factors with ankle-brachial index (ABI) score and category. Methods: This was a cross-sectional study under a consecutive sampling frame conducted from 1 November 2022 to 31 January 2023 at Universitas Airlangga Hospital, Surabaya. Primary data for ABl were measured from T2DM patients with DFU in the Thoracic and Cardiovascular Polyclinic. Meanwhile, secondary clinical data were collected from the Department of Internal Medicine based on the inclusion and exclusion criteria specified in the patient's medical records. The International Business Machines Corporation (IBM) Statistical Package for Social Sciences (SPSS) version 26 was utilized for the statistical analysis. Results: Out of 30 included patients, 63.33% had uncontrolled diabetic status, and the average ABI score was 0.999 ± 0.19. DFU severity was significantly associated with the ABI score and ABI category. Patients indicated with angioplasty exhibited a markedly lower ABI score than those without (mean 0.32 vs 1.01; p < 0.001). Indication of angioplasty was the only clinical factor significantly associated with a lower ABI score (p < 0.001). Conclusion: The status of T2DM was unrelated to ABI. Future research is recommended to advance the understanding of peripheral artery disease in diabetic foot ulcer patients.
Amplatzer vascular plug for alternate treatment in pelvic congestive syndrome in Dr. Soetomo General Hospital: A case report Raharjo, Fumansha Cipto; Danang Himawan Limanto
Journal of Indonesia Vascular Access Vol. 4 No. 1 (2024): (Available online : June 2024)
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v4i1.41

Abstract

Introduction: One of the common causes of chronic pelvic pain in reproductive-age women is pelvic congestion syndrome (PCS). This pain can be constant or intermittent for 3-6 months, occurring throughout the menstrual cycle, arising in the abdominal or pelvic area, and is not related to pregnancy. Complaints of chronic pelvic pain are as much as 10-20% of gynecological consultations, and only 40% of them are referred to specialists for evaluation. 10 – 60 % of PCS is caused by insufficient iliac vein, ovarica vein, or both. Incompetent ovarian vein ligation can head to a favorable result. An endovascular technique using an embolization coil, glue, foam, or amplatzer can be an alternative treatment for PCS.  Case Description : Women 50 years old whom a history of chronic pelvic pain, CT angiography showed Left ovarica vein dilatate and prominant. Durante operation, approach from a right femoral vein with a catheter to the left renal and ovarian veins. Amplatzer vascular plug was deployed at the left ovarian vein and evaluated. There wasn’t insufficient. The Patient was discharged the day after the operation. Conclusion : In conclusion, venous occlusion with vascular plug for PCS management is safe and effective with an embolization agent or surgery with a significant enhancement in pelvic symptoms for PCS.
Clinical outcomes of splenorenal shunts in esophageal varices patients: a literature review Putra, I Gusti Agung Made Adnyana; Hakim, Arief Rakhman; Soebroto, Heroe; Sembiring, Yan Efrata; Limanto, Danang Himawan; Rizki, Mohamad; Puruhito
Journal of Indonesia Vascular Access Vol. 4 No. 1 (2024): (Available online : June 2024)
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v4i1.40

Abstract

The disease known as esophageal varices is usually caused by portal hypertension. Portal hypertension is most commonly caused by extrahepatic portal vein thrombosis and other conditions, such as cardiac problems or hepatic cirrhosis. Clinical manifestations of esophageal varices can include melena, haematemesis, and gastrointestinal bleeding. Effective venous pressure reduction is achieved via the distal splenorenal shunt. We acquired the literature for our review from PubMed and Google Scholar. The search was done in English using terms that indicated a connection between improvements in bone grafting methods and the restoration of alveolar clefts. To expand the search results, we also looked through the papers cited in the literature. Almost all of the five gathered articles demonstrated that the distal splenorenal shunt (DSRS) is a beneficial surgical treatment that effectively avoids postoperative PH issues. Finally, DSRS is presented as a surgical long-term treatment for variceal esophageal reflux disease and portal hypertension. Because DSRS selectively decompresses the venous collaterals around the stomach and lower esophagus, it is a safe and effective therapy choice for decreasing bleeding over nonselective shunting surgeries as a selective shunt.
Co-Authors Andreas Rama Arkananta Nugraha Atika Budi Utomo Hakim, Arief Rakhman Hana Anisah, Hana Ketut Putu Yasa Ni Kadek Sulistyaningsih Nyoman Saka Ranuartha Permana, Putu Bagus Dharma Puruhito Putra, I Gusti Agung Made Adnyana Raharjo, Fumansha Cipto Rizki, Mohamad Sembiring, Yan Efrata Setiawan, Philia Soebroto, Heroe Soebroto, Heroe Suryantoro, Satriyo Dwi Zanella Yolanda Lie