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All Journal Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Cermin Dunia Kedokteran
Rarsari Soerarso
Faculty of Medicine, University of Indonesia/ Harapan Kita National Cardiovascular Center
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience Public Health

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Pengalaman Awal Tindakan MitraClip di Pusat Jantung Nasional Harapan Kita, Jakarta Almazini, Prima; Hersunarti, Nani; Soerarso, Rarsari; Budi Siswanto, Bambang; Firman, Doni; M Soesanto, Amiliana
Cermin Dunia Kedokteran Vol 43, No 3 (2016): Kardiologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (594.129 KB) | DOI: 10.55175/cdk.v43i3.27

Abstract

Latar Belakang: MitraClip merupakan pilihan terapi untuk pasien regurgitasi katup mitral berat yang berisiko tinggi untuk operasi. Tujuan penelitian ini adalah melaporkan tindakan MitraClip di Pusat Jantung Nasional Harapan Kita Jakarta. Metode: Penelitian retrospektif di Pusat Jantung Nasional Harapan Kita, Jakarta. Data diperoleh dari database komputer dan rekam medis dari Februari 2014 sampai Januari 2015, kemudian dianalisis dengan SPSS. Hasil: Enam orang pasien berusia 51 – 75 tahun, menjalani tindakan MitraClip; 5 pasien regurgitasi katup mitral berat dan 1 pasien regurgitasi katup sedang. Satu pasien perempuan dan 5 pasien laki-laki. Dua pasien merupakan regurgitasi mitral degeneratif dan 4 pasien regurgitasi mitral fungsional. Dua pasien dipasangi satu buah MitraClip dan 4 pasien dipasangi dua buah MitraClip. Setelah tindakan, derajat regurgitasi berkurang menjadi ringan pada 2 pasien dan menjadi sedang pada 4 pasien. Dimensi diastolik akhirventrikel kiri berkurang dari 66 ± 6,5 mm saat awal menjadi 59 ± 7,3 mm (p=0,04) saat pulang. Dimensi sistolik akhir ventrikel kiri berkurang dari 50 ± 10,6 mm saat awal menjadi 48 ± 10,0 mm saat pulang (p=0,27). Satu bulan setelah tindakan MitraClip, 2 pasien dengan kelas fungsional I dan 4 pasien dengan kelas fungsional II. Tidak ada pasien yang meninggal dalam perawatan di rumah sakit. Satu pasien perawatan ulang di rumah sakit karena gagal jantung. Simpulan: MitraClip merupakan pilihan terapi yang efektif dan aman untuk pasien regurgitasi mitral degeneratif dan fungsional yang risiko tinggi untuk operasi. Dimensi ventrikel kiri, kelas fungsional NYHA, derajat keparahan regurgitasi katup, dan tingkat perawatan ulang mengalami perbaikan setelah dipasang MitraClip.
Antibiotic Susceptibility among Infective Endocarditis Population: Syndromic Antibiogram Evaluation at Indonesian National Cardiovascular Center Indrawati, Lilik; Sugianli, Adhi Kristianto; Prakoso, Baskoro Justicia; Gunawan, Adrian; Soerarso, Rarsari; Soesanto, Amiliana M.; Dewi, Andaru Dahesih
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 1 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i1.2223

Abstract

Infective Endocarditis (IE) is a life-threatening disease with a high mortality rate (25%). Laboratory approaches to support the diagnosis of IE especially blood and/or cardiac vegetation culture, are crucial for providing definitive therapy. However, negative culture is frequently observed, therefore empirical use of antibiotics seems unavoidable and may lead to increasing antimicrobial resistance. This study aims to observe the prevalence of antibiotic susceptibility among the IE population using the WISCA approach. This retrospective study observed medical record data of all inpatients diagnosed with IE according to ICD-10 at Cardiovascular Center Harapan Kita Hospital (NCCHK) between January 2018 and December 2022. Patient data were combined with bacterial identification and antibiotic susceptibility test data from the laboratory information system, and evaluated based on period (year). A total of 67,858 inpatients and 1.1% (n=772) were diagnosed with IE. Successful culture growth (blood and/or cardiac vegetation specimen) was between 36.8% and 70% annually. Streptococcus viridans group (82/237, 34.6%) and Coagulase-negative Staphylococci (57/237, 24.1%) were dominantly observed among the IE population. Low susceptibility among Penicillin (34.3%) towards Gram-positive bacteria, as first-line treatment option in IE. Meanwhile, high susceptibility range was observed in Ceftriaxone (95.7%), Gentamicin (80.4%), Rifampicin (84.4%), and Vancomycin (98.7%) as second-line treatment in IE. Despite the low prevalence, the occurrence of antimicrobial resistance in IE has become a priority concern. Continuing the syndromic antibiogram is mandatory to assist the trend of empirical antibiotic usage and refine the established local treatment guidelines.
Co-Authors Adhi Kristianto Sugianli Adrian Gunawan, Adrian Amiliana M. Soesanto Andaru Dahesihdewi Bambang Budi Siswanto Doni Firman Lilik Indrawati, Lilik Nani Hersunarti Prakoso, Baskoro Justicia Prima Almazini