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Correlation between Age and Defect Size with Increased Pulmonary Arterial Pressure in Adult Atrial Septal Defect (ASD) Patients at Cardiology and Vascular Medicine Department dr. Seotomo Public Hospital Surabaya 2019-2021 Astrid Aulia Artiono Puteri; Yudi Her Oktaviono; Agung Prasmono
Cardiovascular and Cardiometabolic Journal Vol. 3 No. 1 (2022): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v3i1.2022.15-21

Abstract: Atrial Septal Defect (ASD) is one of the three most common types of congenital heart disease in the world. Pulmonary arterial hypertension (PAH) is a complication that can be found in patients with secundum type of ASD. There is no research that shows the relationship between patient’s age and defect size with increased pulmonary artery pressure in secundum type of ASD patients in Indonesia, so further research needs to be done. Material and Methods: This study is a retrospective study using an observational analytical research design with cross sectionalapproach. The data from this study were taken from the medical records of ASD patients at the Cardiology and Vascular Department of Dr. Soetomo Public Hospital Surabaya. Results: Sex distribution of patients with secundum ASD was dominated by female patients with a total of 53 people (81.5%), the age distribution of patients was dominated by patients in the age group of 20-24 years as many as 18 people (27.7%). The most common comorbidities in adult secundum ASD patients were hypertension (3.08%) and minor CAD (3.08%). The mean diameter of the secundum ASD defect was 28.03±9.57 mm, and the data for the smallest defect diameter was 4 mm and the largest was 48 mm. Complications of increased PA pressure were dominated by 20 patients with mild PH (30.8%) and the mean mPAP pressure was 39.87±19.03. There were no patients with Eisenmenger syndrome Conclusion: There was no correlation between patient age and inter-atrial septal diameter with mPAP pressure. Keywords: Adult, mean Pulmonary Arterial Pressure (mPAP), pulmonary hypertension (PH), secundum Atrial Septal Defect (ASD)

Diagnosis dan Terapi Non-farmakologis pada Hipertensi Pandit Bagus Tri Saputra; Ariikah Dyah Lamara; Mahendra Eko Saputra; Rakha Achmad Maulana; Irien Eko Hermawati; Hanang Anugrawan Achmad; Rachmat Ageng Prastowo; Yudi Her Oktaviono
Cermin Dunia Kedokteran Vol 50 No 6 (2023): Edisi CME
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v50i6.624

Pada tahun 2019, hipertensi diderita oleh 1,28 milyar jiwa di seluruh dunia dan diperkirakan terus meningkat setiap tahun. Saat ini, hipertensi masih menjadi salah satu penyebab utama morbiditas dan mortalitas global. Terdapat perubahan paradigma diagnosis hipertensi menjadi lebih direkomendasikan dengan pemeriksaan tekanan darah di luar klinik (out-of-office blood pressure measurement) berupa pemeriksaan tekanan darah ambulatoar (PTDA) jika fasilitas memadai atau pemeriksaan tekanan darah di rumah (PTDR) pada fasilitas lebih terbatas. Manajemen pasien hipertensi berfokus pada kontrol tekanan darah untuk meningkatkan kualitas hidup serta menurunkan angka kecacatan dan kematian dengan terapi farmakologis dan non-farmakologis. Terapi non-farmakologis telah terbukti membantu mengontrol tekanan darah, menurunkan morbiditas dan mortalitas, baik individu hipertensi maupun individu normal. In 2019, hypertension was suffered by 1.28 billion people worldwide and is expected to increase every year. Hypertension is still one of the main causes of global morbidity and mortality. There is a paradigm shift that diagnosis of hypertension is more recommended by out-of-office blood pressure measurement. Blood pressure measurements outside clinic can be done with ambulatory blood pressure or home blood pressure in limited facilities. Management of hypertensive patients focuses on blood pressure control with pharmacological and non-pharmacological method to improve quality of life, as well as to reduce morbidity and mortality. Non-pharmacological approach has been proven to optimize blood pressure control, to reduce morbidity and mortality in both hypertensive and normal individuals.

Android Application for Initial Screening of Atrial Fibrillation Using The Dempster Shafer Method Rizky Widya Rachmawati; Endah Purwanti; Marcella Aurelia Yatijan; Yudi Her Oktaviono; M. Arief Bustomi
Indonesian Applied Physics Letters Vol. 4 No. 1 (2023): June
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/iapl.v4i1.48159

Atrial Fibrillation (FA) is one of the most common types of heart rhythm abnormalities found in clinical practice in Indonesia. Atrial fibrillation can cause a stroke risk 5 times. Meanwhile, stroke cases themselves tend to rise and become one of the main causes of death every year. The cause of the high number of FA cases is the lack of public knowledge and awareness/sensitivity to the early symptoms of the disease. The purpose of this study was to design an android device for early screening of suspected FA through examination of pulse, complaints/symptoms and disease risk factors. The dempster shafer method is used as a decision making tool for suspected FA or not FA. The results of the detection system performance test, obtained a sensitivity of 93.5%, a specificity of 89.7%, and an accuracy of 91.7%. The test results of the android application design, namely Visual Design and User Interaction, Functionality, Stability and Performance and Overall Satisfaction, show a "good" response in all aspects.

Reperfusion Time of STEMI Patients in Indonesia and Outside Indonesia Muhammad Fachriyan Romadhona; Yudi Her Oktaviono; Sundari Indah Wiyasihati; Rosi Amrilla Fagi
Cardiovascular and Cardiometabolic Journal (CCJ) Vol. 4 No. 2 (2023): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v4i2.2023.85-98

Highlights: 1. The median of door-to-ballon in handling STEMI and total ischemic time is longer in Indonesia than other countries. - Background: STEMI is a medical emergency that requires quick treatment. Several problems might arise from the improper and delayed treatment of STEMI patients. Objective: This study aimed to examine the differences in the reperfusion time of STEMI patients in Indonesia and outside Indonesia. Method: Systematic Review method is used without meta-analysis. The variables to be studied in this study are Door-to-Balloon time and Total Ischemic Time. PubMed, Science Direct, and Scopus are used as search tools using the MeSH terms and keywords that have been determined to look for articles within 2017 – 2020. The selection of the literature that has been obtained was carried out according to the PRISMA algorithm. Results: Twelve journals were used that were relevant, compatible, and following the inclusion and exclusion criteria. It was found that the median door-to-balloon in handling STEMI in Indonesia ranged from 70 to 94 minutes, while the median total ischemic time ranged from 275 to 461 minutes. Meanwhile, the median door-to-balloon time and total ischemic time outside Indonesia ranged from 41 to 87 minutes and 112 to 273 minutes, respectively. Conclusion: In conclusion, the median and average door-to-balloon time and total ischemic time in Indonesia are longer than the door-to-balloon time and total ischemic time outside Indonesia in handling STEMI.

Current Insights on Percutaneous Coronary Intervention in Non-ST Elevation Acute Coronary Syndrome Oktaviono, Yudi Her
Heart Science Journal Vol. 5 No. 3 (2024): The Science and Art of Revascularization in Acute Coronary Syndrome
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.03.1

Percutaneous coronary intervention (PCI) is a cornerstone in the management of non-ST elevation acute coronary syndrome (NSTE-ACS), offering significant improvements in patient outcomes. Risk stratification is critical in guiding the urgency and timing of PCI, with invasive strategies recommended for high-risk patients identified by clinical, electrocardiographic, biomarker assessments, or validated scores. Multivessel coronary artery disease is frequently observed in patients with NSTE-ACS and is correlated with an increased likelihood of recurrent myocardial infarction and mortality. Preferably during the index procedure, complete revascularization should be considered in patients with stable hemodynamics. Functional invasive evaluation, including fractional flow reserve, may help assess the hemodynamic significance of coronary lesions and decide whether a non-culprit stenosed vessel prompts revascularization. Intravascular imaging techniques with optical coherence tomography and intravascular ultrasound are essential for evaluating lesion characteristics, optimizing stent deployment, and enhancing the precision of PCI. Overall, a personalized interventional approach in NSTE-ACS incorporating risk stratification, timely intervention, careful consideration of multivessel disease, and advanced diagnostic modalities is paramount in enhancing patient prognosis and minimizing recurrent ischemic events....

Diagnosis dan Terapi Non-farmakologis pada Hipertensi Pandit Bagus Tri Saputra; Ariikah Dyah Lamara; Mahendra Eko Saputra; Rakha Achmad Maulana; Irien Eko Hermawati; Hanang Anugrawan Achmad; Rachmat Ageng Prastowo; Yudi Her Oktaviono
Cermin Dunia Kedokteran Vol 50 No 6 (2023): Edisi CME
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v50i6.624

Pada tahun 2019, hipertensi diderita oleh 1,28 milyar jiwa di seluruh dunia dan diperkirakan terus meningkat setiap tahun. Saat ini, hipertensi masih menjadi salah satu penyebab utama morbiditas dan mortalitas global. Terdapat perubahan paradigma diagnosis hipertensi menjadi lebih direkomendasikan dengan pemeriksaan tekanan darah di luar klinik (out-of-office blood pressure measurement) berupa pemeriksaan tekanan darah ambulatoar (PTDA) jika fasilitas memadai atau pemeriksaan tekanan darah di rumah (PTDR) pada fasilitas lebih terbatas. Manajemen pasien hipertensi berfokus pada kontrol tekanan darah untuk meningkatkan kualitas hidup serta menurunkan angka kecacatan dan kematian dengan terapi farmakologis dan non-farmakologis. Terapi non-farmakologis telah terbukti membantu mengontrol tekanan darah, menurunkan morbiditas dan mortalitas, baik individu hipertensi maupun individu normal. In 2019, hypertension was suffered by 1.28 billion people worldwide and is expected to increase every year. Hypertension is still one of the main causes of global morbidity and mortality. There is a paradigm shift that diagnosis of hypertension is more recommended by out-of-office blood pressure measurement. Blood pressure measurements outside clinic can be done with ambulatory blood pressure or home blood pressure in limited facilities. Management of hypertensive patients focuses on blood pressure control with pharmacological and non-pharmacological method to improve quality of life, as well as to reduce morbidity and mortality. Non-pharmacological approach has been proven to optimize blood pressure control, to reduce morbidity and mortality in both hypertensive and normal individuals.

Thrombocytopenia in a Patient Undergoing Primary Percutaneous Coronary Intervention Oktaviono, Yudi Her; Meuthia, Feranti
Folia Medica Indonesiana Vol. 55, No. 1
Publisher : Folia Medica Indonesiana

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Thrombocytopenia is a common abnormality in patients presenting with acute coronary syndrome. Baseline thrombocytopenia in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention is associated with early adverse events, related to both ischemia and bleeding. Treatment for acute coronary syndrome usually involves antiplatelet, anticoagulant, antithrombotic therapy, and the performance of percutaneous coronary intervention. The safety of antiplatelet therapy and percutaneous coronary intervention patients who have acute coronary syndrome and thrombocytopenia is unknown, and there are no guidelines or randomized studies that specifically suggest a treatment approach in such patients. One of the institutions in Italy recommends medical and interventional strategy with radialis as first choice for access site, bare metal stent (BMS) implantation, followed by double antiplatelet therapy (DAPT) for one month. After DAPT discontinuation, at least one antiplatelet drug (aspirin) is recommended for life.

Case report: endovascular stenting in peripheral arterial disease of lower extremity Oktaviono, Yudi Her
Folia Medica Indonesiana Vol. 52, No. 2
Publisher : Folia Medica Indonesiana

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Peripheral arterial disease (PAD) is usually caused by multilevel atherosclerotic disease, typically in patients with a history of cigarette smoking, diabetes mellitus, or both. Intermittent claudication (IC), an early manifestation of PAD, commonly leads to reduced quality of life for patients who are limited in their ambulation. Percutaneous intervention for peripheral artery disease has evolved from balloon angioplasty for simple focal lesions to multimodality techniques that enable treatment of severe arterial insufficiency. Especially for high-grade stenoses or short arterial occlusions, percutaneous transluminal angioplasty (PTA) should be the method of first choice followed by the best surgical procedure later on. To achieve good long-term efficacy, a close follow-up including objective tests of both the arterial lesion and hemodynamic status, surveillance of secondary preventive measures and risk factor control is mandatory.

Case report: retrograde approach for cto lesions: serial case Oktaviono, Yudi Her
Folia Medica Indonesiana Vol. 52, No. 4
Publisher : Folia Medica Indonesiana

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Chronic total occlusion recanalization still represents the final frontier in percutaneous coronary intervention. Successful revascularization is associated with improved long-term survival, reduced symptoms, improved left ventricular function and reduced need for coronary bypass surgery. Retrograde chronic total occlusion recanalization has recently become an essential complement to the classic antegrade approach. Retrograde approach through the collateral channel has been recently proposed and has the potential to improve the success rate of percutaneous coronary intervention (PCI) in chronic total occlusion (CTO) lession of the coronary arteries. We report several cases of successful CTO recanalization procedure using retrograde approach in Soetomo Hospital.

Case report: intraprocedural stent thrombosis in percutaneous coronary angioplasty Oktaviono, Yudi Her
Folia Medica Indonesiana Vol. 52, No. 1
Publisher : Folia Medica Indonesiana

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Stent thrombosis is a rare complication of PCI but associated with STEMI and sudden cardiac death. Intra procedural stent thrombosis (IPST) was defined new or increasing (compared with baseline) thrombus within or adjacent to a deployed stent occurring the index PCI procedure whether occlusive or nonocclusive. We describe a case with double vessel disease who has complication cardiac arrest and intra procedural stent thrombosis in LAD and Left Main coronary artery after deployed stent in bifurcation LAD-D1. Thrombectomy and rescucitation were performed, and the patient completed her hospital course without complications.

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