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All Journal Indonesian Journal of Cardiology Zona Kedokteran: Program Studi Pendidikan Dokter Universitas Batam
Amiliana Mardiani Soesanto
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Dentistry Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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Left Atrial Thrombus Resolution Using Unfractionated Heparin and Warfarin in a Patient with Mitral Stenosis Zainuddin Zainuddin; Endang Ratnaningsiah; Andika Rizki Lubis; Sebastian Andi Manurung; Tike Hari Pratikto; Amiliana Mardiani Soesanto
Jurnal Kardiologi Indonesia Vol 40 No 3 (2019): Indonesian Journal of Cardiology: July-September 2019
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v40i3.870

Abstract

Abstract Background: Though the use of Low Molecular Weight Heparin (LMWH) in general is preferred due to its convenient and eliminates the need for activated Partial Thromboplastin Time ( aPTT) monitoring but Unfractionated Heparin (UFH) is still widely used in clinical setting due to its availability and low price. Besides UFH, the use of oral anticoagulant therapy with warfarin, has been the standard therapy for the prevention of thromboembolism in patients with AF. Our aim is to report a case of the resolution of left atrial thrombus in a patient with mitral stenosis. Case Illustration: A Case report of a female patient aged 54 years who admitted with a sudden neurological deficits and mitral stenosis with atrial fibrillation. Transthoracal Echocardiography (TTE) showed mobile thrombus which moved and obstructed the mitral valve during diastolic phase. Unfractionated heparin (UFH) was administered 3000 unit bolus intravenously and maintained with 600 unit per hour with the combination of warfarin 2 mg for five days. TTE evaluation showed the resolution of LA thrombus. Conclusion : The administration of the combination of UFH and warfarin had successfully caused resolution of the LA thrombus and prevented the patient from surgical intervention. This case report indicated that Unfractionated Heparin and Warfarin were still the treatments option in LA thrombus patients with mitral stenosis and atrial fibrillation. Key words :Left atrial thrombus, unfractionated heparin, thrombus resolution
HUBUNGAN MITRAL VALVE GRADIENT TERHADAP KAPASITAS FUNGSIONAL PROTOKOL BRUCE TERMODIFIKASI PADA STENOSIS MITRAL RHEUMATIK PASCA KOMISUROTOMI MITRAL TRANSKATETER PERKUTAN (KMTP) Surya marthias; Amiliana Mardiani Soesanto; Ade Meidian Ambari; Basuni Radi; Amir Aziz AlKatiri
Zona Kedokteran: Program Studi Pendidikan Dokter Universitas Batam Vol 15 No 1 (2025): Zona Kedokteran: Program Studi Pendidikan Dokter Universitas Batam
Publisher : Universitas Batam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37776/zked.v15i1.1635

Abstract

Abstrak Latar belakang: Studi sebelumnya menyimpulkan bahwa MVG merupakan parameter yang berhubungan perbaikan gejala pasca KMTP. Tujuan: Evaluasi hubungan MVG terhadap perubahan kapasitas fungsional pasca KMTP. Metode: Studi quasi experimental dilakukan terhadap 78 subjek. Pemeriksaan ekokardiografi dan treadmill Bruce termodifikasi dilakukan 1-2 hari sebelum dan 1-2 minggu setelah KMTP. Data sebelum dan setelah KMTP dianalisis untuk mencari hubungan variabel terhadap perbaikan kapasitas fungsional pasca KMTP. Hasil: Rerata usia adalah 42 tahun, mayoritas perempuan, dan rerata IMT 22,27 kg/m2. Sebelum KMTP, 53% memiliki irama sinus dengan mayoritas memiliki fungsi ventrikel kiri yang baik dan ventrikal kanan yang baik. Sebesar 97% pasien datang dengan kelas NYHA II sebelum KMTP dan mengalami perbaikan signifikan kapasitas fungsional berupa perbaikan median lama latihan (241 ke 603 detik, p < 0,001) dan perbaikan median nilai VO2max estimasi (18,8 ke 32,8 mlO2/kg/menit, p<0,001). Dari uji korelasi, didapatkan variabel usia (r -0,23, adjusted R2=4,1%), pre-MVG (r 0,23, adjusted R2=4,2%), ∆ MVG (r 0,31, adjusted R2= 9,0%), dan pre-TR Vmax (r 0,3, adjusted R2=1,3%) berkorelasi terhadap perubahan kapasitas fungsional. Penurunan MVG > 50 % pasca KMTP (OR 2,89, p = 0,038) dan TR Vmax sebelum KMTP > 3,4 m/s (OR 3,42, p = 0,023) menjadi prediktor perbaikan kapasitas fungsional segera pasca KMTP. Kesimpulan: Penurunan MVG lebih dari 50% pasca KMTP berhubungan dengan perbaikan kapasitas fungsional segera pasca KMTP. Kata Kunci: fungsional, KMTP, lama latihan, MVG, stenosis mitral
Co-Authors Ade Meidian Ambari Amir Aziz AlKatiri Andika Rizki Lubis Basuni Radi Endang Ratnaningsiah Sebastian Andi Manurung Surya marthias Tike Hari Pratikto Zainuddin Zainuddin