Garuda - Garba Rujukan Digital

Managing a Challenge Case: Transesophageal Echocardiography-Guided Transcatheter Closure of a Large Secundum Atrial Septal Defect in a Pregnant Woman Fathoni, Emil; Martini, Heny; Rahimah, Anna Fuji; Putri, Valerinna Yogibuana Swastika
Heart Science Journal Vol. 5 No. 2 (2024): Challenges in the Management of Congenital Heart and Structural Heart Diseases
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.02.12

Background: The management of complex cardiovascular conditions during pregnancy poses unique challenges, and in the case of a large secundum atrial septal defect (ASD), achieving successful closure through a transcatheter approach guided by transesophageal echocardiography (TEE) requires careful navigation and expertise. This study sought to present a case that exemplifies the contemporary approach of using TEE guidance for the closure of an ASD in pregnant womenCase presentation: A 31-year-old woman with multigravida, diagnosed with secundum ASD and pulmonary hypertension, underwent TEE. The TEE examination revealed a significant ASD measuring 2.8-3.1 cm with inadequate surrounding rims. Subsequently, our intention was to employ a device to address this defect. TEE was utilized to guide the placement of a 14F delivery sheath into the left upper pulmonary vein and left atrium. Using a catheter, we successfully deployed a 40 mm ASD Occluder (MemoPart), concluding the intervention without any complications. Given the concerns regarding the potential risks of radiation exposure and teratogenic effects on fetal development, particularly in young patients and during pregnancy, it is crucial to prioritize TEE-guided closure of ASD for the safety of both the mother and the fetus.Conclusion: Closure of ASD with zero fluoroscopy proved to be a safe and effective procedure, demonstrating feasibility and significant benefits for pregnant women with ASD.

Sudden Cardiac Death In Young Age, What Should We Know? Rochmawati, Icmi Dian; Rizal, Ardian; Putri, Valerinna Yogibuana Swastika; Prasetya, Indra
Heart Science Journal Vol. 5 No. 2 (2024): Challenges in the Management of Congenital Heart and Structural Heart Diseases
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.02.7

While young sudden cardiac death (SCD) is statistically uncommon, its dramatic presentation and the impact it has on families and communities make it a newsworthy issue. Nonetheless, it is important to view SCD in children and adolescents as a public health concern and devise strategies based on research and consensus to address it. Both individuals with and without a history of cardiovascular illness are susceptible to sudden cardiac death. Employing cardiovascular disease risk screening for healthy individuals and those with a family history of sudden cardiac death can serve as a preventive approach against sudden cardiac death. Assessing the severity of cardiovascular disease in people becomes essential in order to prevent disease progression and minimize the risk of mortality from cardiovascular conditions.

Impact of Strict and Lenient Heart Rate Control on Six-Minute Walk Test and Quality of Life in Atrial-Fibrillation Patients with Rheumatic Mitral Stenosis : Randomized Control Trial Dwigustiningrum, Nur Kaputrin; Rizal, Ardian; Putri, Valerinna Yogibuana Swastika; Rahimah, Anna Fuji; Rohman, Mohammad Saifur; Wikananda, Adhika Prastya; Waranugraha, Yoga; Astiawati, Tri; Laitupa, Fitranti Suciati
Heart Science Journal Vol. 5 No. 2 (2024): Challenges in the Management of Congenital Heart and Structural Heart Diseases
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.02.8

Background: Recent studies showed no outcome difference between strict and lenient rate control in the general Atrial Fibrillation (AF) population. However, for AF and Rheumatic Mitral Stenosis (RMS) patients, evidences were lacking.Objective: To assess the impact of strict and lenient heart rate control on the Six-Minute Walk Test (SMWT) and Health Related Quality of Life (HRQoL) in patients with AF and RMS.Material and Methods: A prospective multicenter trial across tertiary hospitals in East Java assessed strict and lenient heart rate control's impact on the SMWT and HRQoL in AF and RMS patients. Sixty-one participants were randomized into strict and lenient groups over six months from March to August 2023. Medications were adjusted to achieve target heart rates, and HRQoL was assessed using SF-36 and SMWT at baseline and three months post-target heart rate attainment.Result: In our study, 29 patients were under strict heart rate control, and 32 were under lenient control. We found a decrease in HRQoL across all subscales, with significant differences observed in general health perception and physical function among those under strict control (p=0.002 and 0.03, respectively). However, no significant disparity was found in the SMWT distance difference between lenient and strict groups (p=0.529), nor in METs (p=0.326).Conclusion: In the study, lenient heart rate control demonstrates significant effects on the general health perception and physical function subscales compared to strict heart rate control.Â

The Association between CHA2DS2-VASc Score with Increased Serum Creatinine Level in ACS Patients Undergoing PCI at RSUD dr. Saiful Anwar Malang Fathoni, Emil; Widito, Sasmojo; Anjarwani, Setyasih; Satrijo, Budi; Putri, Valerinna Yogibuana Swastika
Heart Science Journal Vol. 4 No. 4 (2023): The Science and Art of Caring for Critically III Patients in Intensive Cardiac
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.04.4

Background: The current literature on the relationship between the congestive heart failure, hypertension, age, diabetes mellitus, prior stroke or TIA or thromboembolism, vascular disease, age, sex category (CHA2DS2-VASc) score and increased Serum Creatinine (SCr) among Acute coronary syndrome (ACS) patients is noticeably limited in scope. Therefore, the primary objective of this study was to assess the correlation between CHA2DS2-VASc score with increased of Serum CreatinineÂ in patients with ACS undergoing Percutaneous coronary intervention (PCI) procedures.Material and Methods: In this study, a total of 527 participants were recruited, comprising two groups: Increased SCrÂ level (n=159) and normal SCr levelÂ (n=368). Data pertaining to clinical information and demographic characteristics, such as gender, age, diabetes mellitus (DM), hypertension (HT), congestive heart failure (CHF), history of stroke or transient ischemic attack (TIA), and vascular disease, were gathered from various sources, including registry data and medical records, diagnostic physical examination, electrocardiography and laboratory records. Logistic regression analysis was employed to assess the association between the CHA2DS2-VASc score and the incidence of increased SCr level.Result: In our study, we observed that the CHA2DS2-VASc scores were significantly higher in the group of patients who increase SCr levelÂ compared to those who did not increase SCr level. Furthermore, our Receiver Operating Characteristic (ROC) analysis revealed that a CHA2DS2-VASc score cutoff of 3Â was determined to be the optimal threshold for estimating the increased SCr levelÂ (AUC= 0.805, 95% CI 0.762-0.848; p<0.01).Conclusion: The CHA2DS2-VASc score serves as a valuable tool for estimating the likelihood of SCrÂ in patients undergoing PCI, offering a foundational assessment. Additionally, in PCI patients, an increase in the CHA2DS2-VASc score exceeding 3Â is indicative of a heightened incidence of increased SCr level.

Reversible atrioventricular block during transcatheter ventricular septal defect closure – a serial case report Indrihapsari, Pratiwi; Putri, Valerinna Yogibuana Swastika
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.20

Background: The transcatheter ventricular septal defect procedure is a sophisticated intervention that carries potential complications, such as complete heart block. We report two cases of patients who experienced total AV block during transcatheter VSD closure and were successfully treated with steroids and atropine. Case Presentation: Perimembranous VSD was found in a 19-year-old military recruit. A baseline 12-lead EKG showed sinus rhythm and no conduction delays. Echocardiography revealed a 6-9 mm perimembranous VSD. Then the VSD was closed with a VSD Occluder No 10-8. ECG monitor and echocardiography showed a complete atrioventricular block during the procedure. Fortunately, 1mg atropine and 125mg methylprednisolone overcame this. Recurrent atrioventricular block and VSD were not found after the procedure. A 33-year-old male patient was diagnosed with a perimembranous VSD during routine screening. Initial 12-lead electrocardiography was unremarkable, while echocardiographic evaluation revealed a 3-5 mm perimembranous VSD. Transcatheter closure was performed using a VSD Occluder device (No. 10-8). Hemodynamic monitoring and echocardiography demonstrated a complete atrioventricular (AV) block intraoperatively. Pharmacological intervention with 1 mg atropine and 125 mg methylprednisolone resolved the conduction disturbance. Despite this transient complication, the procedure continued with successful device deployment. Post-procedural assessment confirmed complete VSD closure with no residual shunt or persistent AV conduction abnormalities. Conclusions: In the context of transcatheter closure of ventricular septal defects, there exists a risk of atrioventricular block, which can be precipitated by mechanical trauma or compression from the delivery system or device. Ensuring the appropriate sizing of the device is pivotal in minimizing this risk. Continuous heart rhythm monitoring is indispensable during both short-term and long-term follow-up periods.

Pregnancy with Bidirectional Dominant Left-To-Right Shunt due to Ventricular Septal Defect and Large Secundum Atrial Septal Defect with Left-To-Right Shunt: A Case Report Destikatari, Lovin; Prasetyorini, Nugrahanti; Putri, Valerinna Yogibuana Swastika
Asian Journal of Health Research Vol. 4 No. 1 (2025): Volume 4 No 1 (April) 2025
Publisher : Ikatan Dokter Indonesia Wilayah Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55561/ajhr.v4i1.218

Introduction: Congenital heart disease (CHD) is the most common birth defect in humans, affecting approximately 0.8% of all live births. The spectrum of defects is broad, ranging from complex defects that lead to severe disability and death in infancy, to mild defects that may only be discovered later in asymptomatic adults. Case Presentation: This case report discusses a 21-year-old female in her second pregnancy was diagnosed with complex congenital heart disease after presenting with shortness of breath. Pulmonary hypertension was established by echocardiography. The woman did not obtain proper therapy since she was not aware of her cardiac problem during her pregnancy. There were no fetal abnormalities found during prenatal exams. At 38 weeks gestation, an IUD-assisted cesarean surgery was scheduled. While a cesarean section is performed on individuals with certain problems, the majority of CHD cases may be successfully delivered vaginally. Another crucial factor to take into account is the choice of postpartum contraception. Conclusion: A personalized strategy is needed to manage congenital heart disease throughout pregnancy. This includes risk education, careful observation, and modification of interventions to guarantee the best possible results for both mother and child.

Transcatheter atrial septal defect closure: Focus on tips and tricks for interventional procedure in challenging cases Setiawan, Dion; Putri, Valerinna Yogibuana Swastika; Martini, Heny; Karolina, Wella
Heart Science Journal Vol. 6 No. 2 (2025): The Complexity in the Management of Heart Rhythm Disorder
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.02.6

The ostium secundum defect is the most prevalent form of atrial septal defect (ASD). The development and refinement of devices and techniques for transcatheter ASD closure have led to its acceptance as the preferred management for most patients with secundum ASD. Meticulous planning and execution constitute the key to achieving success in a procedure. It entails a thorough assessment of the patient, beginning with selecting suitable cases, as well as detailed pre- and intraprocedural imaging, knowledge of various device deployment techniques, anticipation of potential complications, and appropriate management strategies. This review article will discuss tips and tricks to overcome the technical intricacies of achieving a successful transcatheter ASD closure and address some challenging cases associated with its use.

Comprehensive Management of Peripartum Cardiomyopathy with Acute Renal Failure: From Prepartum to Renal Replacement Therapy – A Case Report Niazta, Nisa Amnifolia; Putri, Valerinna Yogibuana Swastika
Asian Journal of Health Research Vol. 4 No. 2 (2025): Volume 4 No 2 (August) 2025
Publisher : Ikatan Dokter Indonesia Wilayah Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55561/ajhr.v4i2.240

Introduction: Peripartum cardiomyopathy (PPCM) is a rare but potentially serious that poses significant diagnostic and therapeutic challenges, particularly in previously healthy women. We report a complex case of severe PPCM in a primigravida patient who needed intensive multidisciplinary care due to respiratory failure and acute renal failure. Case Presentation: A 21-year-old primigravida in 34 weeks of gestation presented with progressive dyspnea and signs of acute heart failure. Despite an unremarkable medical history, she exhibited severe left ventricular dysfunction (LVEF of 28%), cardiomegaly, and pulmonary congestion. Rapid deterioration necessitated urgent caesarean delivery under general anesthesia due to maternal and fetal distress. Postoperatively, the patient developed cardiogenic shock and acute kidney injury (AKI) necessitating vasopressor and continuous renal replacement therapy (CRRT). Intensive heart failure management, including bromocriptine therapy and guideline-directed medical treatment, led to gradual hemodynamic stabilization. She was successfully weaned off mechanical ventilation and CRRT within days, ultimately being discharged after 12 days of treatment with improved cardiac function. Conclusion: This case underscores the unpredictable nature and rapid progression of PPCM, even in the absence of traditional risk factors. Early recognition, prompt multidisciplinary intervention, and individualized therapy are critical to improving maternal and neonatal outcomes.

Early Detection of Congenital Heart Disease in Pregnant Young Women at Risk Putri, Valerinna Yogibuana Swastika
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.2022.003.03.1

Cardiovascular disease (CVD) is one of the non-communicable diseases in which the leading cause of death worldwide at 48%1. CVD contains a spectrum of diseases, one of which is Congenital Heart Defect (CHD). CHD is one of the contributors to morbidity from young until adulthood. The advancement of surgical correction and medical therapy made it possible for early structural correction, as uncorrected CHD while patients were still young posed a risk of health outcome deterioration later in life. CHD affected especially pregnant individuals. A pregnant woman diagnosed with CHD would often complain of significantly significant deterioration of health condition and quality of life as they have a higher susceptibility to cardiovascular complications than women in general. Pregnant women diagnosed with CHD in developing countries more often presented with signs indicating complications of CHD, such as Eisenmenger syndrome, signs of heart failure, Pulmonary Hypertension (PH), cyanosis, and NYHA functional classes II and III, which indicate later diagnosis and treatment further into adulthood in these patients. Lack of expertise and facility for diagnosis of CHD posed a major challenge in reducing mortality related to CHD in these countries. Therefore the need for a screening method at least for directing further referral to major health centers is still in high demand.

Successful Pregnancy in Uncorrected Tetralogy of Fallot with Right Aortic Arch: An Interdisciplinary Team Approach Millisani, Hayla Iqda; Putri, Valerinna Yogibuana Swastika
Heart Science Journal Vol. 5 No. 1 (2024): Inflammation and Cardiovascular Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.01.8

Background: Tetralogy of Fallot (ToF) is the most common cyanotic disorder, with a global prevalence of congenital heart disease nearly reaching 10%. The anomalies observed in individuals with ToF result from the anterior and cephalad displacement of the infundibular (outflow tract) component of the interventricular septum. ToF continues to be a significant contributor to maternal morbidity, mortality, and adverse outcomes in newborns with the condition.Case presentation: An 18-year-old woman in her 28th week of pregnancy was referred to our tertiary referral center, Saiful Anwar Hospital, diagnosed with uncorrected Tetralogy of Fallot (TOF), which had been noticed since she was 2 years old. At that time, her parents refused treatment. She became pregnant unexpectedly and was then directed to RSSA for further management.Conclusion: We present a successful case of pregnancy in a woman who has not undergone surgical repair for ToF. An interdisciplinary pregnancy heart team, including a cardiologist, obstetrician, anesthesiologist, midwives, and neonatologists at our tertiary hospital, developed a care plan based on an individualized assessment of the patient's comorbidities and ToF. The life expectancy of this pregnant woman and her baby is higher with a team approach. The choice of contraception and family planning should be part of the discussion and follow-up from the teenage years, allowing patients with ToF to control their fertility and make informed decisions about having children.

Title

Found 11 Documents
Search

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Title Search

Found 11 Documents Search

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Title

Found 11 Documents
Search