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All Journal Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Journal of Indonesia Vascular Access
Wartono, Dicky Aligheri
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Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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The effect of bicuspid aortic valve versus tricuspid aortic valve as a risk factor for aortic dilatation: a systematic review and meta-analysis Rianda, Rama Azalix; Danindra, Ivan; Wartono, Dicky Aligheri
Journal of Indonesia Vascular Access Vol. 5 No. 2 (2025): Available online : 1 December 2025
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v5i2.65

Abstract

Background: The enlargement of the ascending aorta (AA) is a frequent finding in clinical practice. Age, gender, and body size have been shown to be important determinants of AA diameter. One of the most prevalent congenital heart conditions is bicuspid aortic valve (BAV) disease, which primarily affects male subjects and has a population prevalence of 0.5% to 2.0%. Purely severely stenotic BAVs developed a moderate dilation of the aorta at an early age, while TAVs (Tricuspid Aortic Valves) did not. This study aims to compare BAV and TAV as risk factors for aortic dilatation. Methods: A systematic literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines by using PubMed/Medline, Scopus, and ScienceDirect databases according to PICO. The studies obtained were adjusted to the eligibility criteria. We conducted a journal appraisal assessment using the CASP 2024 tools for the 10 included studies. Meta-analysis was performed using Review Manager 5.4. Result: Out of 208 studies, 10 studies are included for a systematic review according to eligibility criteria. From the baseline characteristics, BAV with aortic dilatation is often seen at a younger age compared to TAV. 5 studies are analyzed for the incidence risk of aortic dilatation between BAV and TAV group (OR 5.16; 95% CI 2.69, 9.92; p<0.001) and 6 studies are analyzed for the aortic diameter between BAV and TAV group (OR 0.55; 95% CI -1.37, 2.46; p<0.58). Conclusion: Our systematic review-meta-analysis study found that there is an increase in ithe ncidence risk of aortic dilatation in BAV patients compared to TAV patients. Our study result supports the guideline designed by the American Association for Thoracic Surgery that suggests patients undergoing concurrent heart surgery, concomitant ascending aorta/root repair should be actively performed when the aortic diameter is 45 mm.
Efektivitas Pemberian Deksametason dalam Memengaruhi Durasi Perawatan di Rumah Sakit Pada Operasi Bedah Pintas Arteri Koroner Off Pump Putra, Rally Galang Pratama; Hanafy, Dudy Arman; Wartono, Dicky Aligheri; Busro, Pribadi Wiranda; Herlambang, Bagus
Majalah Kedokteran Indonesia Vol 71 No 6 (2021): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.71.6-2021-746

Abstract

Introduction: The off pump coronary artery bypass surgery (OPCAB) technique is expected to be able to eliminate the side effects and complications caused by the use of a cardiopulmonary bypass (CPB) machine. However, this technique is not completely free from side effects or complications. One of the effects that can be caused is an increase in the systemic inflammatory response, so that the duration of hospitalization becomes longer. This is aim of this study to conduct a study of the administration of dexamethasone for reduced the length of hospital stay in patients undergoing OPCAB surgery. Methods: This was an analytic observational study with sixty patients who underwent OPCAB surgery and were randomized to either dexamethasone or placebo groups of 30 people each. Clinical results were analyzed. Results: The length of stay in the dexamethasone group compared to the placebo group was consecutive (5 (5-8) days vs 6.5 (5-30) days; p=0.04) so that there was a significant difference. Other clinical outcomes in the dexamethasone group were better than the placebo group, in terms of duration of mechanical ventilation (p=0.03) and intensive care unit stay (p=0.03). There were significant differences in inflammatory markers between the two groups: interleukin-6 (p=0.0001), procalcitonin (p=0.0001), and C-reactive protein (p=0.0001) were lower in the dexamethasone group. Conclusion: Preoperative dexamethasone in patients undergoing off-pump coronary artery bypass is effective in reducing the length of hospital stay and controlling postoperative inflammatory reactions.
Co-Authors Bagus Herlambang Danindra, Ivan Hanafy, Dudy Arman Pribadi Wiranda Busro Putra, Rally Galang Pratama Rianda, Rama Azalix