Sasmojo Widito
Department Of Cardiology And Vascular Medicine, Faculty Of Medicine, Universitas Brawijaya, Malang, Indonesia

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Journal : Heart Science Journal

Diastolic Dysfunction Following Acute Myocardial Infarction with ST Segment Elevation Imelda Krisnasari; Anna Fuji Rahimah; Sasmojo Widito; Cholid Tri Tjahjono
Heart Science Journal Vol 3, No 2 (2022): Improving ST-Elevation Myocardial Infraction Patients Prognosis
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2022.003.02.2

Abstract

ST segment elevation myocardial infarction (STEMI) caused by atherosclerotic vulnerable plaque rupture or plaque erosion, resulting in activation of the coagulation cascade. It causes a temporal sequence known as the “ischemic cascade,” which first involves the metabolic process, the diastolic dysfunction, and then systolic dysfunction. Diastolic dysfunction in STEMI patient is an independent predictor for long-term outcome. Rapid and early restoration of blood flow is critical to ensure cell recovery and prevent additional damage. 
Management of Acute Uncomplicated Stanford B Aortic Dissection in The Era of Endovascular Repair: A Case Report Putri Annisa Kamila; Novi Kurnianingsih; Sasmojo Widito; Djanggan Sargowo; Budi Satrijo
Heart Science Journal Vol 1, No 3 (2020): Management of Coronary Artery Disease: From Risk Factors to The Better Long-Term
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2020.001.03.8

Abstract

Introduction:Uncomplicated type B aortic dissections have been traditionally treated with medication therapy. While it may provide good short-term results, longterm prognosis may be less favorable. With improvements in endovascular repair and the potential risk of disease progression, thoracic endovascular aortic repair (TEVAR) has been considered inpatients with uncomplicated type B aortic dissection. We present the case of 78-year-old gentleman who presented with acute uncomplicated type B aortic dissection managed by endovascular repair Case illustration:A 78 year-old hypertensive patient admitted to the hospital with persistent chest discomfort and cough for 2 weeks. The CT aortic angiogram showed type B dissection. Based on the recent guidelines, TEVAR should be considered in patients with uncomplicated type B aortic dissection, thus we prepared the patient for TEVAR procedure. First we established multidisciplinary vascular team for the pre-procedural preparation of the patient. We perform careful measurement through detailed CT angiography reconstruction from carotid to femoral arteries. We found proximal diameter was 30-35mm, distal diameter was 23mm and landing zone right after left brachial ostium, suitable for stent graft Valiant Captivia 36-32x150mm. The CT also showed that both femoral artery were normal, we decided to use right femoral artery as the access. We proceed to the procedure 2 days later, under general anaesthesia, digital subtraction angiography revealed dissection of descending aorta, and selected device was inserted. Subsequent contrast injection revealed total occlusion of the false lumen. Patient was transferred to ICU for postprocedural care, and extubated the day after. The hospital stay was uneventful, and one-month follow up CT shows no endoleak. Conclusion :Management of uncomplicated Stanford B dissections is very challenging. TEVAR has emerged as an alternative to surgery with lower morbidity and mortality rates that might offer good long-term results. 
Management of Antithrombotic Therapy in Post PCI Patient Undergoing Pericardiotomy due to Large Pericardial Effusion : A case report Dedy Irawan; Sasmojo Widito; Mohammad Saifur Rohman; Cholid Tri Tjahjono
Heart Science Journal Vol 2, No 4 (2021): Management of Thrombosis in Covid-19 Patient with Cardiovascular Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2021.002.04.9

Abstract

Background : Stent thrombosis is a serious complication following percutaneous coronary intervention (PCI), and dual antiplatelet therapy (DAPT) is necessary to avoid it. Surgery, on the other hand, is a common cause for stopping DAPT. Because patients were exposed to the possibility of a major adverse cardiovascular event (MACE) when DAPT was stopped, this circumstance poses a clinical dilemma.Objective : This case report aimed to describe the management of antithrombotic therapy in post PCI patient requiring DAPT who underwent pericardiostomy.Case : A 69-year-old woman with large pericardial effusion without cardiac tamponade, breast cancer on chemo- therapy, heart failure stage C NYHA functional class II, chronic coronary syndrome post-DES implantation at proximal-mid LAD, and hypertension. The patient underwent pericardiotomy procedures five days after DAPT discontinuation. For the bridging therapy, continuous UFH administration was initiated at a dose of 18 IU/kg/hour after the cessation of DAPT. The UFH dose was adjusted to achieve activated partial thromboplastin time (APTT) 1.5 to 2.0 times the control value. The UFH was discontinued 6 hours before surgery. After surgery, UFH infusion was restarted 6 hours after the confirmation of hemostasis. The administration of UFH then continued until three days after DAPT was restarted. No complications were found during and after the pericar- diostomy.Conclusion : We reported an antithrombotic treatment strategy in a post PCI patient undergoing pericardiostomy with discontinuation of DAPT, which was successfully treated with UFH without any complication. The UFH has been widely used in perioperative settings as a bridging therapy during the interruption of DAPT and may be considered in this condition. 
Myocardial Revascularization in COVID-19 Era Sasmojo Widito
Heart Science Journal Vol 2, No 3 (2021): The Science and Art of Myocardial Revascularization
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2021.002.03.1

Abstract

Coronavirus disease 2019 (COVID-19) is a highly contagious disease caused by the coronavirus 2 that causes severe acute respiratory syndrome (SARS-CoV-2). More discussion is required to achieve the balance between clinical benefit and risk in the treatment of acute coronary syndrome (ACS) patients with COVID-19. The current COVID-19 pandemic prompts the need to evaluate criteria for indication and efficacy of the general safety protocols and particular cardiac catheterization laboratory (CCL) procedures to safeguard the patient and healthcare professionals
Acute Decompensated Heart Failure: Current Role of Diuretics and Ultrafiltration Dea Arie Kurniawan; Indra Prasetya; Sasmojo Widito; Heny Martini
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.2023.004.01.2

Abstract

Acute decompensated heart failure (ADHF) continues to be the leading cause of hospitalization and has a poor prognosis. Loop diuretic had been long used as cornerstone therapy for congestion and volume overload. However, several factors including diuretic resistance and declining renal function reduced the loop diuretic's effectiveness, necessitating a different treatment strategy. In ADHF, ultrafiltration (UF) could be a promising method to volume management. UF appears to be more effective at removing fluid than diuretics, according to several studies, with better quality of life and lower rehospitalization. This review highlights the current state of knowledge regarding the use of diuretics and UF in ADHF patients, as well as the challenges and questions raised associated with each approach.