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All Journal The New Ropanasuri Journal of Surgery Jurnal Health Sains
Makdinata, William
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Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Veterinary

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Bidirectional Cavopulmonary Shunt Surgery of Tetralogy of Fallotwith Situs Inversus and Levocardia in 20-Month-Old Boy : A Rare Case Report Wardoyo, Suprayitno; Susanti, Dhama Shinta; Makdinata, William; Jeo, Albert
Jurnal Health Sains Vol. 4 No. 10 (2023): Journal Health Sains
Publisher : Syntax Corporation Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46799/jhs.v4i10.1099

Abstract

Tetralogy of Fallot (TOF) is a relatively common cyanotic congenital heart disease, characterized by four distinct defects. Although TOF is a common condition, its association with situs inversus and levocardia is rare, presenting diagnostic and treatment challenges. This case report discusses a 20-month-old boy with TOF, situs inversus, and levocardia. Initially planned for total surgical correction, intraoperative anatomical complexities led to the decision to perform a bidirectional cavopulmonary shunt surgery. This procedure aimed to enhance oxygen saturation and reduce the volume load on the right ventricle, due to severe pulmonary stenosis and perimembranous ventricular septal defect. The bidirectional cavopulmonary shunt serves to improve systemic arterial oxygen without increasing ventricular work or pulmonary vascular resistance. This case highlights the significance of individualized treatment approaches when TOF is associated with complex anatomical variations
Effect of Ischemia-Reperfusion injury and Preconditioning on Lung Parenchyma after Acute Limb Ischemia Hutagaol, David; Susanti, Dhama S; Soeharto, Wuryantoro; Putra, Muhammad A; Wardoyo, Suprayitno; Makdinata, William; Setiawan, Moira
The New Ropanasuri Journal of Surgery Vol. 7, No. 1
Publisher : UI Scholars Hub

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Abstract

Introduction. Acute limb ischemia, a sudden decrease of perfusion to the extremities, can compromise the survival of the limbs. Medical intervention and surgery are often needed to return perfusion. However, reperfusion injury can trigger oxidative stress and inflammatory response, leading to local and remote tissue damage, such as the lungs, which increases morbidity and mortality. This research aims to study the effects of hypothermia and remote ischemic preconditioning (RIPC) on the lung parenchyma after being exposed to reperfusion after acute limb ischemia in rabbits. Method. Eighteen New Zealand White rabbits were divided into three groups of 6. The femoral artery was ligated to induce ischemia. The hypothermia group was given cooling pads to maintain a temperature of 28°C for 4 hours, and the RIPC group was assigned RIPC before ligation for 5 minutes in three cycles. Both groups underwent reperfusion for eight hours. Evaluation of histologic characteristics was performed independently by a pathologist. Results. The mean scores for the control group, hypothermia group, and RIPC group were 12.03 + 1.43 (severe injury), 8.03 + 3.03 (moderate injury), and 4.80 + 2.61 (mild injury), respectively. In addition, there was a significant difference between lung parenchymal damage in the control group and hypothermia group (p = 0.015) and between the control group and RIPC group (p = 0.000). Conclusion. Both hypothermia and RIPC have a protective effect on lung parenchyma exposed to remote reperfusion injury after lower limb ischemia, where RIPC protects the lungs to a higher degree.
Co-Authors Hutagaol, David Jeo, Albert Putra, Muhammad A Setiawan, Moira Soeharto, Wuryantoro Susanti, Dhama S Susanti, Dhama Shinta Wardoyo, Suprayitno