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All Journal Jurnal Anestesiologi Indonesia Heart Science Journal Journal of Medicine and Health
Radityo Prakoso
Faculty of Medicine, University of Indonesia/ Harapan Kita National Cardiovascular Center
Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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The Current Strategy in Managing Congenital and Structural Heart Disease: Find and Treat Them Appropriately Prakoso, Radityo
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.2024.005.02.2

Abstract

Significant progress has been made in diagnosing and treating congenital heart defects (CHDs) over the past five decades. Notable advancements include pulse oximetry screening for critical CHDs in newborns and percutaneous, catheter-based procedures, improving outcomes even in developing nations. Recent studies demonstrate favorable outcomes with device closure of acyanotic CHDs, with non-fluoroscopy techniques adopted to minimize radiation risks. Positive results are observed with right ventricular outflow tract (RVOT) stent palliation for late-presenting cyanotic congenital heart diseases such as tetralogy of Fallot (TOF). Novel interventions like reverse Potts shunt anastomosis show promise in managing pediatric pulmonary arterial hypertension (PAH), while prophylactic treatments effectively reduce postoperative arrhythmias. Fontan procedure significantly enhances survival rates for individuals with single functional ventricles, although challenges arise with aging populations. In developed countries, fetal cardiac interventions utilizing advanced imaging techniques allow for early detection and preventive interventions, reducing secondary complications.
Successful High-Risk Pulseless-Balloon Aortic Valvuloplasty Procedure in Uncorrected Pulmonary Atresia with Severe Congenital Aortic Stenosis and Low Left Ventricular Function Sofia, Sefri Noventi; Bahrudin, Bahrudin; Riwanto, Ignatius; Susanto, Hardhono; Soetadji, Anindita; Baskoro, Adhi Gunawan; Prawara, Ananta Sidhi; Satyagraha, Muhammad Thifan; Kurniawati, Yovie; Prakoso, Radityo
JAI (Jurnal Anestesiologi Indonesia) Vol 17, No 3 (2025): JAI (Jurnal Anestesiologi Indonesia)
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.72347

Abstract

Background: Pulmonary atresia with ventricular septal defect (PA-VSD) and severe bicuspid aortic stenosis is an uncommon condition that presents significant surgical challenges. The dual obstruction leads to chronic pressure overload, resulting in ventricular hypertrophy and decreased systolic function. A low left ventricular ejection fraction (LVEF) increases the risk of mortality during surgical interventions. Percutaneous balloon aortic valvuloplasty (PBAV) poses additional risks due to the intentional induction of pulselessness during balloon inflation. This case report aims to detail the perioperative management strategies employed during PBAV in a patient with PA-VSD, severe aortic stenosis, and low LVEF.Case: We present a 19-year-old female patient weighing 45 kg with shortness of breath and fatigue. Her oxygen saturation was measured at 90% across all extremities. Electrocardiogram (ECG) findings indicated sinus rhythm with biventricular hypertrophy and incomplete left bundle branch block (LBBB). Chest X-ray revealed cardiomegaly and pulmonary artery dilation, while echocardiography confirmed PA-VSD, severe aortic stenosis with a mean pressure gradient (mPG) of 55 mmHg, and an LVEF of 41.3%. A percutaneous pulseless-BAV was performed using a Tyshak balloon via an antegrade transvenous femoral approach under fluoroscopy and transesophageal echocardiography guidance.Discussion: Anesthesia management focused on gradual medication titration, minimizing patient movement during the procedure, and ensuring comfort due to transesophageal echocardiogram (TEE) probe insertion. A temporary pacemaker was placed in the right ventricular apex for pacing at 220 beats per minute until cardiac arrest occurred post-balloon inflation, and defibrillation successfully restored spontaneous circulation.Conclusion: This case illustrates that PBAV in uncorrected PA-VSD with severe aortic stenosis and low LVEF is feasible despite its inherent risks when conducted by a skilled team utilizing careful judgment throughout the procedure.
KARAKTERISTIK PASIEN PENYAKIT JANTUNG BAWAAN DI RUMAH SAKIT JANTUNG PEMBULUH DARAH NASIONAL HARAPAN KITA PERIODE TAHUN 2019–2023 Abednego, Nathaniel; Situmorang, Desman; Setiabudi, Edwin; Lelya, Olfi; Prakoso, Radityo
Journal of Medicine and Health Vol 8 No 1 (2026)
Publisher : Universitas Kristen Maranatha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.28932/jmh.v8i1.11332

Abstract

Congenital heart disease (CHD) is one of the most common congenital disorders, affecting approximately 8 per 1,000 live births in Indonesia. This study aimed to describe the demographic and clinical characteristics of pediatric patients with CHD treated at Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita from 2019 to 2023. A descriptive cross-sectional study was conducted using medical record data from 5,599 patients under the age of 18. Variables analyzed included annual case distribution, demographic characteristics, CHD classification, complications, and treatment outcomes. The highest number of cases was recorded in 2023 (1,457 cases; 26.02%). Most patients were under five years old (59.94%), with a slight female predominance (50.94%). Acyanotic CHD was more prevalent (60.33%), predominantly ventricular septal defect (53.11%), while cyanotic CHD accounted for 39.67%, dominated by Tetralogy of Fallot (59.70%). Congestive heart failure and pulmonary hypertension were the most frequent complications. Cyanotic CHD was associated with growth and developmental disorders and malnutrition, whereas acyanotic CHD generally demonstrated adequate nutritional status. The most common intervention was total repair of Tetralogy of Fallot. Surgical success rates were high in acyanotic (97.37%) and cyanotic CHD (94.73%). Mortality was higher in cyanotic CHD, particularly with delayed diagnosis. Early detection improves outcomes significantly overall.
Co-Authors Abednego, Nathaniel Anindita Soetadji Bahrudin Bahrudin Baskoro, Adhi Gunawan Budi Nagawijaya Edwin Setiabudi Erika Maharani Hardhono Susanto Ignatius Riwanto, Ignatius Kurniawati, Yovie Lelya, Olfi Muhammad Munawar Prawara, Ananta Sidhi Robert E. Saragih Satyagraha, Muhammad Thifan Sefri Noventi Sofia Situmorang, Desman Yoga Yuniadi Yoga Yuniadi