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All Journal Heart Science Journal Pediatric Sciences Journal Journal of Community Health and Preventive Medicine (JOCHAPM)

Heny Martini

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

Author-ID : 3606284

Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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Trapping Technique for Successful Retrieval of a Ruptured Balloon Catheter Entrapped in Coronary Artery : A Case Report Putri Annisa Kamila; Budi Satrijo; Mohammad Saifur Rohman; Heny Martini; Indra Prasetya
Heart Science Journal Vol 1, No 2 (2020): The Assessment of Diagnostic and Treatment Modality in Heart Failure
Publisher : Universitas Brawijaya

Introduction: Device entrapment during PCI is an uncommon complication with incidence of less than 1%. Percutaneous retrieval should be favored as the treatment of choice for this condition.Case Illustration: A 61-year-old patient came for an elective percutaneous coronary intervention (PCI) procedure. She suffered from chest pain while doing moderate activities for 1 month. Angiography showed a diffuse lesion with maximum stenosis 90% in the proximal LAD, stenosis 75% in the proximal of Left Circumflex Artery (LCx), and diffuse lesions in the proximal and mid of the Right Coronary Artery (RCA). We decided to perform PCI in the LAD. A transfemoral coronary intervention was performed using a Judkins Left 3.5 (7F) guiding catheter to engage the LAD. A Guidewire ( Run-through NS Floppy) was advanced to the distal LAD. Balloon angioplasty was performed with a 2.75 x 15 mm Fluydo balloon in the proximal LAD at 16 bars, but the balloon was entrapped and while withdrawing the balloon, it accidentally ruptured in the LAD artery with the remaining segment inside the guiding catheter. A second Run-through NS Floppy Guidewire was inserted across the ruptured balloon and a 2.5 x 20 mm Fluydo Balloon was passed on the second wire and was inflated at 16 atm pressure, inside the guiding catheter, trapping the ruptured balloon. The ruptured balloon was successfully removed, by withdrawing the whole system, including the guiding catheter and the wire. Finally, we re-engaged the LAD with the same guiding catheter, passed the wire, and post dilated the stent on the LAD to achieve a good result.Conclusion: Percutaneous retrieval using trapping technique could represent a safe and effective technique for ruptured and entrapment of a balloon-catheter in a coronary artery.

The Combination of Oral PDE5-Inhibitor (Sildenafil) And Oral Prostacyclin Analogue (Beraphrost) Therapy for Increasing Quality of Life in Adults with Pulmonary Arterial Hypertension Related to Uncorrected Secundum Atrial Septal Defect Heny Martini; Muhammad Rizki Fadlan; Akhmad Isna Nurudinulloh
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.2021.002.04.5

Background : Sildenafil, an oral phosphodiesterase type-5 inhibitor, has vasodilatory effects through a cyclic guanosine 3,5-monophosphate–dependent mechanism, whereas beraprost, an oral prostacyclin analog, induces vasorelaxation through a cAMP-dependent mechanism.Objective : To investigate whether the combination of oral sildenafil and beraprost is superior to sildenafil alone in in adult patients with PAH related uncorrected secundum ASD.Method : Patients with secundum ASD who developed PAH divided into two group. Group A received oral sildenafil 3x40 mg and oral beraphrost 3x20mcg. Group B received oral sildenafil only 3x40 mg in a 12-week. Health-related quality of life (HRQoL) was recorded by patients using the Medical Outcomes Study 36-item short form (SF-36) questionnaires at baseline and after 12 of therapy. Therapy adherence was achieved through a series of phone calls and a four-weekly hospital visit. Every normal follow-up appointment included an examination of side effects and a dosage modification based on the clinical situation.Results : We didn’t found any significant of proportion different in Comorbid condition between groups. Compared with Group B, Group A had increased in physical functioning, Limitation to physical health, Energy fatigue, Pain, and health change (P=0.00, P=0.03, P=0.044, P=0.026, P=0.008, respectively).Conclusion : We suggest that combination between oral sildenafil therapy 40 mg three times per day and Beraphrost 20mcg two times per day significantly increase the HRQOL in PAH patients due to uncorrected secundum ASD.

Profile of Pediatric Rheumatic Heart Disease Patients with Mitral Regurgitation Receiving Angiotensin-Converting Enzyme Inhibitor in dr. Saiful Anwar General Hospital Malang Faris Wahyu Nugroho; Muhammad Saifur Rohman; Ardian Rizal; Heny Martini; Indra Prasetya; Taufieq Ridlo Makhmud
Heart Science Journal Vol 2, No 2 (2021): Dealing with Vascular Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2021.002.02.3

AbstractBackground : Rheumatic heart disease (RHD) remains the leading cause of heart failure in children worldwide. Long-term consequences and sequelae of acute rheumatic fever may further contributes to isolated mitral regurgitation (MR), unless promptly treated, may develop to extensive fibrosis and calcification leading to mitral stenosis. ACE inhibitor through reverse remodeling mechanisms may encounter secondary LV changes due to rheumatic MR. Studies in the field of RHD remain limited, particularly in Indonesia. Method : This observational descriptive study recruited 69 pediatric patients diagnosed with RHD who went to Pediatric Cardiology Clinic of dr. Saiful Anwar General Hospital during November 2018 to June 2019. A total of 22 patients were excluded due to incomplete data or showing no MR during echocardiography. The remaining samples (47 patients) were divided into two groups i.e: captopril and no captopril group. Data regarding profile of baseline characteristics, parameter of LV remodeling (dimension, mass and geometry), and grading of MR were collected then tabulated using descriptive statistical analysis. Results : In general, from total 47 of sample population, female sex was found to predominate (68%), with mean age of 12.1 years and body mass index (BMI) 17.2 kg/m2. Proportion of distribution among captopril and no captopril group demonstrated no significant difference (p>0.05). Captopril group revealed younger age, higher BMI and longer time of initial RHD diagnosis compared to no captopril group. Evaluation of LV remodeling parameter demonstrated that captopril group had smaller LVIDd, lower LVMI, higher fractional shortening (FS) and higher LVEF. LVPWd dan RWT were found to be relatively similar among both groups. Evaluation of MR grade revealed that captopril group showed lower value of MR VC, MR EROA and MR regurgitant volume. Conclusion : Profile of pediatric RHD patients with MR who had been receiving captopril for at least 12 months in dr. Saiful Anwar General Hospital during period of 2018-2019 demonstrated younger age, higher BMI, smaller LVIDd, lower LVMI, lower MR grade, higher FS and higher LVEF compared to patients who had not. Keywords: rheumatic heart disease, mitral regurgitation, ACE inhibitor, captopril, left ventricle remodeling

Peripartum Cardiomyopathy (PPCM): How to Diagnose and Deal with? Monika Sitio; Cholid Tri Tjahjono; Heny Martini; Novi Kurnianingsih
Heart Science Journal Vol 2, No 1 (2021): How to Diagnose Heart Failure and Deal with The Treatment Complexity
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2021.002.01.08

Peripartum cardiomyopathy (PPCM) is a diagnosis of exclusion, where patients present with heart failure (HF) secondary to left ventricular (LV) systolic dysfunction without any other cause of HF identified in the last month of pregnancy or within first five months after delivery, abortion, or miscarriage. PPCM is a life-threatening condition which frequently under diagnosed and inadequately treated, whereas the morbidity and mortality rate ranges between 7% and 50%. Early diagnosis is important to decrease morbidity and mortality. Therefore, it is necessary to report the case related to this condition.A 34-year-old woman was referred to RSSA with worsening shortness of breath (SOB). She has given birth about 2.5 months prior to admission. History taking and supporting findings form this case were supported to diagnosis of PPCM. She was treated with diuretic, aldosterone antagonist, ACE-I, beta blocker, anticoagulant, and bromocriptine. The symptoms were improved in the following days. She was discharged with better condition and educated to comply with medication.

The Nightmare in Defect Occlusion by Transcatheter: A Case Report Iskandar Iskandar; Seprian Widasmara; Ratna Pancasari; Heny Martini
Heart Science Journal Vol 3, No 3 (2022): Cardiovascular Disease in Young Adulthood: Who, When, and How to Screen?
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2022.003.03.7

Background : ASD closure ASD closure with a transcatheter is the first choice in patients who meet the criteria for insertion. Closure using this method is relatively safe, and has low complications. Several factors must be considered so that this closure action can be optimal. Case illustrations:A 24-year-old woman with complaints of shortness of breath during strenuous activities since 3 years ago. Transthroracal echocardiography showed a gap in the IAS of 1.7-1.9 cm. The patient then underwent TEE and DXRL. The patient was planned for percutaneous ASD closure with zero fluoroscopy. The patient was punctured on the right femoral, and entered into the occluder memopart no 24 mm. Do a wriggle test, the occlude tool is installed properly. When the device was pulled out, the patient's blood pressure dropped to 75/52. On TEE examination, pericardial effusion was found and pericardiocentesis was performed, obtained 600 cc of fluid. The patient was then observed in the ICVCU, and there was no additional free fluid in the pericardial cavity. Discussions:ASD closure can be done through percutaneous and surgery. Closure via percutaneous is the main option. Complications and treatment period is shorter than surgery. Preparation and timing of appropriate action is closely related to clinical outcomes. Observation and knowledge of the risks of the procedure are very important to be able to detect complications and optimize clinical outcomes.

Secondary Hypertension due to Abdominal Coarctation; How do we identify and manage it?: A Case Report Oktafin Srywati Pamuna; Novi Kurnianingsih; Anna Fuji Rahimah; Heny Martini
Heart Science Journal Vol 3, No 3 (2022): Cardiovascular Disease in Young Adulthood: Who, When, and How to Screen?
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2022.003.03.6

BackgroundCoarctation of the abdominal aorta (AoA) is a very uncommon condition, accounting for 0.5-2 percent of all aortic stenosis cases. We present an 11-year-old child who has been diagnosed with abdominal aorta coarctation. Case IllustrationAn 11-years old boy complained about dizziness since 1.5 years ago with hypertension. He underwent hypertension treatment for 1.5 years with a pediatrician but there is no improvement in his blood pressure. His current blood pressure was 150/95 mmHg in upper extremities and 120/80 mmHg in lower extremities with three antihypertensives drugs. We found bruit in the abdomen and decreases pulse in lower extremities. An echocardiogram shows no congenital defect. The first was on suspicion of renal stenosis and underwent ultrasonography of the abdomen but was not conclusive. Computed Tomography Angiographic (CTA) showed severe stenosis in the abdominal aorta on level thoracal 11-12. Aortogram shows significant stenosis in the abdominal aorta with a pressure gradient was 47 mmHg. He underwent percutaneous transluminal angioplasty with BMS self-stent implantation. At two months of follow up his blood pressure target was achieved with a minimal dose of oral antihypertensive drugs DiscussionHow to diagnose coarctation of the abdominal aorta is still challenging and often underdiagnosed. Patients with young age and persistent hypertension should be more careful in diagnosis. A bruit in the abdomen with a weak pulse in the lower extremity raises suspicion of Coarctation of the Abdominal Aorta. An angioplasty procedure, either with or without a stent or a surgery might be used as the primary therapy.

The importance of correct management in a 15-year-old boy with severe pulmonary arterial hypertension associated with patent ductus arteriosus Dyahris Koentartiwi; Devi Albaiti Jannati; Ardhanis Ramadhanti; Heny Martini
Pediatric Sciences Journal Vol. 3 No. 2 (2022): Available online : 1 December 2022
Publisher : Medical Faculty of Brawijaya University, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/pedscij.v3i2.44

Background: Pulmonary arterial hypertension (PAH) is a condition in which pulmonary vascular pressure increases and is associated with diverse diseases or aetiologies. In children, 50% of PAH cases are caused by congenital heart disease (CHD), especially due to large left-to-right shunts. Large systemic to pulmonary shunts may develop in PAH if left untreated or repaired late. PAH, when present, markedly increases morbidity and mortality in patients with CHD. Case presentation: We present a 15-year-old boy with a large patent ductus arteriosus (PDA) and severe pulmonary arterial hypertension. Catheterization under general anaesthesia was performed at the age of 16 years. We performed an acute vasoreactivity test (AVT), with the AVT result showing pulmonary arterial hypertension with high flow and low resistance. Transcatheter closure (TCC) of PDA was performed, resulting in no residual PDA. Meanwhile, the echocardiographic finding showed that there was still class II pulmonary arterial hypertension. We then gave heart failure medication and selective pulmonary vasodilator for 6 months. Post-treatment, pulmonary artery systolic pressure was significantly lower (TR Vmax 2.31 m/s, TR Max PG 21 mmHg, estimated PAP 24 mmHg). In this case, clinical evaluation, CXR, ECG, echocardiography, and cardiac catheterization data were presented with a review of the current guidelines regarding the management of paediatric patients with PAH associated with PDA. Summary: TCC of PDA is an option to treat pulmonary hypertension in PDA patients. Combined use of drugs and TCC PDA proves beneficially synergistic effect with better outcomes and may reduce mortality.

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

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.

CARDIOVASCULAR DISEASE AMONG ADOLESCENCE IN SMPN 5 MALANG: A CROSS-SECTIONAL SURVEY STUDY Cholid Tri Tjahjono; Fandy Hazzi Alfata; Heny Martini; Indra Prasetya; sawitri satwikajati
Journal of Community Health and Preventive Medicine Vol. 1 No. 1 (2021): JOCHAPM Vol. 1 No. 1 2021
Publisher : Universitas Brawijaya

Cardiovascular disease (CVD) is the leading cause of death in Asia-Pacific, although highly preventable, CVD was the cause of an estimated 9.4 million deaths. It accounted for one-third of all deaths in 2016. Hypertension is one of cardiovascular disease risk factors. Early detection of cardiovascular disease is the main issues to reduce the prevalence of the cardiovascular disease. Adolescence was the population in which the modifiable cardiovascular risk factor firstly developed. In the year 2018, Indonesian Health Ministry discovered that the prevalence of the cardiovascular disease in East Java was 0.2 % higher than national prevalence and Malang as one of the biggest cities in East Java with high population growth, hence early detection of cardiovascular disease become highlight issue. This cross-sectional survey was held in September 2019 at SMPN 5 Malang, which participated by 123 students (75 females and 48 males). Bivariate analysis was done to examine the correlation between each variable, and logistic regression was done to the most influential variable. Seventy-eight per cent of students were sedentary lifestyle with physical activities < 300 minutes/week, 16.2 % of students were an active smoker, and all were male. Among 123 students, 0.8 % with no cardiovascular risk factor, 29.2 % had 1 risk factor, 30.8 % had 2 risk factors, 27.6 % had 3 risk factors, and 11.3 % had 4 risk factors. The most prevalent risk factors were sedentary life (80 %), increase waist circumference (50 %), passive smokerÂ (48.5 %), overweight & obesity (15 %), and active smoker (14,6 %). Waist circumference above normal was more prevalent in female (65 %) than male (31%). Hypertension had been found in 14.6 % of students and had a significant correlation with heart rate (p 0.011)

Aortic Intramural Hematoma Mimicking Acute Coronary Syndrome Zainal Fathurohim; Novi Kurnianingsih; Djanggan Sargowo; Heny Martini
Heart Science Journal Vol 4, No 2 (2023): Dealing with the Complexity of the Wide Spectrum of Cardiovascular Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.02.5

Abstract :Type A Aortic intramural haematoma (IMH), a variant form of classic aortic dissection, has been accepted as an increasingly recognised and potentially fatal entity of acute aortic syndrome.It is a very dangerous, fatal, and emergency condition. It is very important to recognize the symptoms of acute aortic syndrome related to appropriate management Case IllustrationA 52 year old man patient suffered from chest pain with moderate intensity while he was working at home. It was sharp , tear-like sensation, in the middle of the chest radiated to the back, accompanied with cold sweating, and did not relieve by rest. Because of this condition he brought to hospital. From examination at Emergency room, he had cardiomegaly, aortic dilatation. From the Electrocardiography an st elevation at V1-V2 and T inverted V4-V6 precordial lead,I aVL extremities lead and slightly elevated cardiac enzymes with risk factors for active smoking and uncontrolled hypertension. Initially he was suspected of having acute coronary syndrome with differential diagnose acute aortic syndrome. To exclude the diagnose he had underwent cardiac catheterization, the cardiologist in charge suspicious this patient with aortic dissection because of trapping contrast durante procedure and coronary minor disease. For a better diagnosis, transtransthoracic echocardiography and Aortic Computed Tomography angiography was performed on the patient which confirmed the evidence of dissection. After being diagnosed, we treat the patient as an acute aortic syndrome and we stabilize the patient's condition. The patient was planned for cardiac surgery DiscussionAcute aortic syndrome, which includes Acute Aortic Dissection, Intramural Hematoma and penetrating aortic ulcer, is difficult to diagnosed. Aortic intramural hematoma, which is one of the acute aortic syndromes, is characterized by the presence of a hematoma in the medial layer of the aortic wall without the appearance of an intimal tear. The incidence of intramural hematoma differs slightly from that of aortic dissection syndrome. Patients with intramural hematomas often occur in older patients, more often with aortic aneurysmsThe patient receive treatment aggressively to control blood pressure by administering a non-dihydropyridine calcium channel blocker intravenously and then beta blocker, angiotensin II receptor blockers, was also needed. Acute aortic syndrome, where an intramural aortic hematoma can present with varying symptoms of varying severity, which can lead to misdiagnosis and delay in cases of life-threatening disease. In the case of our patient, who had strong cardiac risk factors, His initial presentation described an acute myocardial infarction; the diagnosis was made after CT scan was performed and the patient remained stable ConclussionComplaints of chest pain due to symptoms of acute aortic syndrome are very important to be recognized immediately because they need proper management. Complaints in this syndrome have similarities with complaints in acute coronary syndrome, pulmonary embolism and others. Patients with aortic intramural hematoma are at high risk for developing periaortic hematoma and hemorrhagic pericardial effusion. In patients with an intramural aortic hematoma, Stanford A, the most appropriate management is surgical technique. Initial management of blood pressure control, heart rate and anti-pain can be given. In this case, the choice of a combination of surgery with endovascular may be a logical choice of therapyKeywordAortic Intramural Hematoma, Acute aortic syndrome

Co-Authors Adhika Prastya Wikananda Aditha Satria Maulana Akhmad Isna Nurudinulloh Anita Surya Santoso Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Annisa Hasanah Ardhanis Ramadhanti Ardian Rizal Ardian Rizal Aris Munandar Zulkifli Ismail Ayu Asri Devi Adityawati Bambang Kusbandono Budi Satrijo Cholid Tri Tjahjono Citra Tarannita Dadang Hendrawan Dea Arie Kurniawan Devi Albaiti Jannati Djanggan Sargowo Djanggan Sargowo Djanggan Sargowo Dyahris Koentartiwi Fahmy Rusnanta Fajar, Jonny Karunia Fandy Hazzi Alfata Faris Wahyu Nugroho Faris Wahyu Nugroho Indra Prasetya Indra Prasetya Indra Prasetya Indra Prasetya Irma Kamelia Iskandar Iskandar Lenny Kartika Mohammad Saifur Rohman Monika Sitio Muhammad Rizki Fadlan Muhammad Saifur Rohman Novi Kurnianingsih Oktafin Srywati Pamuna Pawik Supriadi Putri Annisa Kamila Ratih Kusuma Wardani Ratna Pancasari Renny Suwarniaty Sasmojo Widito sawitri satwikajati Seprian Widasmara Seprian Widasmara Setyasih Anjarwani Taufieq Ridlo Makhmud Taufieq Ridlo Makhmud Wira Kimahesa Anggoro Yoga Waranugraha Zainal Fathurohim

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