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All Journal Journal of Anesthesiology and Clinical Research
Ruddi Hartono
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

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Perioperative Considerations for ASD Device Closure in the First Trimester: A Case of Secundum ASD with Bidirectional Shunt Nugroho, Yusuf Agung; Isngadi; Ruddi Hartono
Journal of Anesthesiology and Clinical Research Vol. 5 No. 3 (2024): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/jacr.v5i3.640

Abstract

Introduction: Atrial septal defect (ASD) closure during pregnancy is a complex procedure requiring careful consideration of maternal and fetal risks. This case report highlights the perioperative management of a secundum ASD with a bidirectional shunt in a patient during her first trimester. Case presentation: A 31-year-old woman, G3P2A0, presented at approximately 10-11 weeks gestation with a recently diagnosed large secundum ASD and pulmonary hypertension. She was on Sildenafil and Bisoprolol. Due to the potential risks associated with an unrepaired ASD during pregnancy, the decision was made to proceed with percutaneous ASD closure. General anesthesia was administered with meticulous hemodynamic monitoring. The procedure was successful, and the patient recovered without complications. Conclusion: ASD closure during the first trimester can be safely performed with careful planning and execution. Multidisciplinary collaboration and vigilant monitoring are crucial for optimal maternal and fetal outcomes.
Anesthesia Management of Cesarean Section in Women with Peripartum Cardiomyopathy: A Case Series Praskita Pande; Ruddi Hartono
Journal of Anesthesiology and Clinical Research Vol. 5 No. 3 (2024): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/jacr.v5i3.652

Abstract

Introduction: Peripartum cardiomyopathy (PPCM) is a rare but serious heart condition that occurs during late pregnancy or within the first few months after delivery. It can lead to significant maternal and fetal morbidity and mortality. Anesthetic management of PPCM patients undergoing cesarean section (C-section) is challenging due to the hemodynamic instability and potential for complications. Case presentation: This case series describes the anesthetic management of four women with PPCM undergoing C-section. Various anesthetic techniques were employed, including combined spinal-epidural (CSE) and epidural anesthesia, with careful monitoring and individualized management strategies. Case 1 present a 34-year-old female with mild mitral regurgitation, mild tricuspid regurgitation, mild pulmonary regurgitation, intermediate probability pulmonary hypertension, hypertensive heart failure, and obesity underwent C-section under CSE anesthesia with ropivacaine and bupivacaine. Case 2 present a 26-year-old female with PPCM and mild mitral regurgitation underwent C-section under CSE anesthesia with ropivacaine and bupivacaine. Case 3 present a 26-year-old female with PPCM, thrombocytosis, and hypoalbuminemia underwent C-section under epidural anesthesia with ropivacaine and fentanyl. Case 4 present a 30-year-old female with PPCM, marginal placenta previa, uterine myoma, and severe myopia underwent C-section under epidural anesthesia with ropivacaine and fentanyl. Conclusion: Regional anesthesia, particularly CSE and epidural techniques, appears to be a safe and effective anesthetic approach for C-sections in women with PPCM. Meticulous hemodynamic monitoring and individualized management are crucial for successful outcomes.
Perioperative Anesthetic Management of Brain Abscess Evacuation in a Child with Double Outlet Right Ventricle: A Case Report Rio Kharisma Putra; Buyung Hartiyo Laksono; Eko Nofiyanto; Fanniyah; Ruddi Hartono
Journal of Anesthesiology and Clinical Research Vol. 6 No. 1 (2025): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/jacr.v6i1.668

Abstract

Introduction: Double outlet right ventricle (DORV) is a rare congenital heart defect where both the aorta and pulmonary artery arise from the right ventricle. This anomaly poses unique challenges for anesthetic management, especially during intracranial surgeries. Case presentation: We present the case of a 7-year-old female child diagnosed with a brain abscess and DORV, who underwent open evacuation and cranioplasty. Anesthetic management focuses on maintaining hemodynamic stability and ensuring adequate oxygenation. The patient was successfully extubated postoperatively and transferred to the intensive care unit (ICU) for close monitoring. Conclusion: Surgical interventions in patients with DORV require careful preoperative evaluation and close perioperative monitoring to minimize morbidity and mortality. This case highlights the importance of a multidisciplinary approach and meticulous anesthetic management in ensuring a successful outcome.
Co-Authors Buyung Hartiyo Laksono Eko Nofiyanto Fanniyah Isngadi Nugroho, Yusuf Agung Praskita Pande Rio Kharisma Putra