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Journal of Indonesia Vascular Access
Published by Indonesian Vascular Access Association
ISSN : 28077032     EISSN : 27986780     DOI : https://doi.org/10.51559/jinava
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology
Journal of Indonesia Vascular Access; peer-reviewed journal aiming to communicate high-quality research articles, reviews, and general articles in the field. INAVA publishes articles that encompass basic research/clinical studies related to the cardiovascular and thorax field. The Journal aims to bridge and integrate the intellectual, methodological, and substantive diversity of medical scholarship and encourage a vigorous dialogue between medical scholars and practitioners.
Arjuna Subject : Kedokteran - Pembedahan
Articles 53 Documents
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Conservative management for type A chronic thoracic aortic dissection on a patient with Marfan Syndrome, "when surgery can't be done": a case report from the rural hospital Swempi Melchiadi Abolla; Charles Saputra
Journal of Indonesia Vascular Access Vol. 3 No. 2 (2023): (Available online: 1 December 2023)
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v3i2.43

Abstract

Introduction: In aortic emergencies, aortic dissection (AD) is one of the most common. This fatal condition affected 2-3 per 100,000 people per year. Predisposing factors initiate the tear through the aorta and create the false lumen. Chronic aortic dissection is often associated with complications that make the aortic wall become weak and can lead to the rupture of the aorta. Chronic aortic dissection also can lead to an ischemic syndrome as a result of gradual impairment of distal perfusion. Emergency surgical intervention in elderly patients with type A aortic dissection is still controversial because of the high postoperative mortality and complication rate. This study aims to discuss the case of a patient who was already diagnosed with chronic aortic dissection with underlying thoracic aortic aneurysm and Marfan syndrome who gets treated conservatively Case Description: We report a case of a 54 years old female who came to the emergency department with the complaint of crushed-felt-like chest pain for the last 3 days accompanied by coughing, nausea, vomiting, and epigastric pain. The patient had been diagnosed with aortic dissection with a thoracic aortic aneurysm two months ago with a history of uncontrolled chronic hypertension and she was also diagnosed with Marfan syndrome. The patient was treated conservatively due to the high risk of mortality and morbidities for cardiac surgery. Conclusion: The decision regarding treatment options for patients with chronic aortic dissection should be considered the outcomes, mortality, and physical function. The physician needs to inform the patient and family about the condition, treatment options, long-term medical management, and the prognosis of the disease.
Pulmonary aspergilloma presenting with recurrent hemoptysis in a patient with previously treated pulmonary tuberculosis: a case report from a rural hospital in Ketapang Regency Herick Alvenus Willim; Eva Lydia Munthe; Widi Mujono
Journal of Indonesia Vascular Access Vol. 3 No. 2 (2023): (Available online: 1 December 2023)
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v3i2.44

Abstract

Introduction: Pulmonary aspergilloma, also known as mycetoma or fungus ball, is a type of pulmonary aspergillosis characterized by colonizing fungi within a preexisting lung cavity, typically in previously healed tuberculosis (TB). We present a case report from a rural hospital in Ketapang Regency, Indonesia, highlighting the complexities of diagnosing and managing pulmonary aspergilloma in a patient with a history of treated pulmonary TB. Case Description: A 32-year-old man with recurrent hemoptysis, fever, weight loss, and productive cough sought care after years of inconclusive tests. Despite a history of pulmonary TB and multiple negative acid-fast bacilli tests, a thorax computed tomography scan showed the presence of aspergilloma within the upper lobe of the left lung. He was given antifungal therapy. During follow-up, he continued to experience recurrent hemoptysis. Eventually, he was referred to a provincial referral hospital with cardiothoracic surgical facilities for definitive surgical management. Conclusion: Pulmonary aspergilloma presents significant challenges in diagnosis and management. Recurrent or massive hemoptysis, a hallmark symptom of this condition, demands vigilant attention in patients with a history of pulmonary TB.
Correlation Between Intraoperative Blood Vessel Diameter and Technical Success Rate of AV Shunt Surgery in Dr. Soetomo Hospital Surabaya Saphira, Diva; Soebroto, Heroe; Thaha, Mochammad; Hakim, Arief Rakhman; Widipriyatama, Gabriel Rio
Journal of Indonesia Vascular Access Vol. 3 No. 2 (2023): (Available online: 1 December 2023)
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v3i2.45

Abstract

Introduction: An arteriovenous (AV) shunt is an anastomosis between vein and artery made in a surgical procedure as vascular access for patients with end-stage renal disease that are projected to undergo hemodialysis. Unfortunately, AV shunt failure remains a significant clinical problem for hemodialysis patients. In general, the cause of most early AV shunt failure is still unknown, but the quality of the blood vessels is suspected as a factor. This study aimed to determine the correlation between blood vessel diameter and the success of AV shunt surgery. Methods: This study is a cross sectional study that uses a descriptive-analytic design. The samples were obtained from the patient’s medical records with the total sampling technique of all patients who have undergone AV shunt surgery from January 2019 – December 2020 at Dr. Soetomo General Hospital which matches the inclusion and exclusion criteria. Results: Patients’ blood vessel diameter measurement is divided into four categories which are <2 mm, 2 - <4 mm, 4 - <6 mm, and ≥6 mm. From a total of 62 patients, the highest successful surgery rate is carried out in patients with a vein diameter of 2 - <4 mm (77.59%) and artery diameter of 2 - <4 mm (63.79%). The results of the Chi-Square analysis found no significant correlation between vein diameter (p=0.769) or artery diameter (p=0.922) and the success of AV shunt surgery at Dr. Soetomo Hospital, Surabaya 2019-2020. Conclusions: In conclusion, this study did not find a correlation between the intraoperative blood vessel diameter and the technical success of AV shunt surgery.
Surgical Management of Vascular Anomalies in Extremities: A Case Series Permatasari, Gita; Tua, Ivan Joalsen Mangara
Journal of Indonesia Vascular Access Vol. 4 No. 1 (2024): (Available online : June 2024)
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v4i1.47

Abstract

Introduction: Vascular malformations and vascular tumors are the two categories of vascular anomalies in the ISSVA categorization system. Although surgery has historically been the primary method of treating vascular abnormalities, it is increasingly frequently combined with other procedures. Thus, the purpose of this study is to outline the several surgical approaches for treating vascular abnormalities in the extremities. Case: In this series study revealed six patiens with vascular malformation who underwent surgical treatment. The locations of the lession more frequently in lower extremity than upper extremity. Few cases need reconstrution using flap or skin graft. Three cases were recurrent hemangiomas which underwent surgical excision before this study. In the follow-up, there were no signs of tumor reccurence after the secondary surgical excision. Four patients had combined therapy with scleroting agent.  Conclusion: Hence, surgical management is constantly the treatment of coice for vascular anomalies. Combined therapy with scleroting agent may use in the case which unable to do expansive excision.
Renal artery coil embolization for management of bleeding in severe renal trauma: a case report Haris; Kokohana, I Putu
Journal of Indonesia Vascular Access Vol. 4 No. 1 (2024): (Available online : June 2024)
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v4i1.48

Abstract

Background: Among genitourinary tract injuries, renal trauma is the most often damaged organ. Renal trauma makes up between 0.3- 3.25 % of all injuries and can cause hemorrhage, damage to the collecting system which could result in urine leakage, or injury to the renal parenchyma or renal vasculature. Clinical stage affects the type of treatment chosen for renal trauma. Grading of renal injury and guiding for treatment and intervention are possible using the AAST grading system. The grades assigned based on renal trauma imaging and clinical features have an impact on the prognosis and treatment plan for the patients. This study aimed to present a renal artery coil embolization in severe renal trauma management. Case presentation: In this report, we describe a 30-year-old man who had a history of a traffic injury an hour prior, along with extensive hematuria and stomach pain. AAST grade V severe renal damage and a sizable hematoma were shown by an abdominal CT scan.To stop the renal bleeding, the patient received endovascular embolization treatment. Four days following the intervention, the patient was released from the hospital without showing any signs of kidney hemorrhage. Conclusion: The minimally invasive technique of endovascular angiography and embolization has demonstrated promising clinical outcomes. This technique can be used to stop bleeding in patients with hemodynamically stable renal injuries and can avoid surgery or nephrectomy in some circumstances.
Simple wire versus figure of 8 wire for sternal closure after sternotomy: a systematic review and meta-analysis Rahayu, Devi Agustini
Journal of Indonesia Vascular Access Vol. 4 No. 2 (2024): Available online : 1 December 2024
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v4i2.49

Abstract

Introduction: Sternotomy is associated with a range of complications, including instability, non-union, and infection, which are among the most frequent issues encountered. The standard closure method for median sternotomy involves the use of simple wires applied in either a figure-of-eight or a simple interrupted configuration. This study aims to compare the effectiveness of simple wires in a figure-of-eight pattern versus the simple wire technique for sternal closure following median sternotomy.   Methods: Data in this study were PubMed, Web of Science, Wiley, Cochrane, ProQuest, Mendeley, and ScienceDirect databases, covering the period from 2019 to 2024. This systematic review included comparative studies evaluating simple wire versus figure-of-eight techniques for sternal closure post-sternotomy. Meta-analysis was performed using Review Manager version 5.4.   Results From an initial pool of 309 articles, 6 studies were identified as eligible for analysis. These studies collectively included 8,236 patients undergoing sternal closure with the figure-of-eight technique and 2,622 patients with the simple wire technique. The meta-analysis revealed a significantly higher rate of sternal dehiscence in patients treated with the simple wire technique compared to those using the figure-of-eight technique, with an odds ratio of 0.35 (95% CI, 0.15–0.81; p = 0.01).   Conclusion: Patients undergoing sternal closure with the simple wire technique exhibited higher rates of sternal dehiscence compared to those treated with the figure-of-eight method. The figure-of-eight wire technique significantly reduced the incidence of sternal dehiscence and appears to be a more effective method for sternal closure after median sternotomy.
Modification of mandibular plates as an alternative for sternal fixation Pakubuana, Muhammad Alif; Nugraha, Aswin; Bermansyah; Satria, Gama; Umar, Ahmat; Tobing, Arie Hasiholan Lumban; Nasution, Indra Hakim
Journal of Indonesia Vascular Access Vol. 4 No. 2 (2024): Available online : 1 December 2024
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v4i2.52

Abstract

Introduction: The use of metallic wires for sternal closure after coronary artery bypass grafting (CABG) is standard practice, but it can lead to rare complications such as subsequent sternal wound dehiscence. These complications necessitate surgical revisions, prolong hospital stays, and increase the risk of morbidity and mortality. The following case report presents a patient who underwent modification of mandibular plates as an alternative for Sternal Fixation. Cases: A 55-year-old female patient with a history of severe coronary artery disease (CAD 3VD) underwent coronary artery bypass grafting (CABG). Postoperatively, she developed a sternal dehiscence, resulting in a sternal fracture. The patient underwent two revisions. The first revision concerns potential damage to the internal mammary artery with the Robicsek technique led to multiple fixations using PDS and large PGA 1 sutures. In the 2nd revision, consequently, the sternum was stabilized with three plates and screws on the ribs in the healthy rib area (sternochondral junction) combined with wire. Additionally, the patient had a history of hypertension, type 2 diabetes mellitus, refractory hypoalbuminemia, postmenopausal osteoporosis, and potential hormonal imbalances. In a recent presentation, a clinical examination revealed a fully conscious patient with stable vital signs and minimal drainage from the sternotomy wound. The treatment plan included close observation of the surgical wound, administration of Amikacin (antibiotic), and supportive therapies such as pain management, glycemic control, and inhalation therapy. She was scheduled for outpatient follow-up with a cardiologist for further cardiac monitoring. Conclusion: The case study highlights the complexities of managing sternal wound complications in cardiac surgery patients with additional health concerns. Innovative solutions like mandibular plates may be particularly beneficial for stabilizing the sternum and promoting recovery in post-CABG patients with crushed sternums and complicating factors such as hypertension, diabetes, and refractory hypoalbuminemia, along with postmenopausal osteoporosis and potential hormonal imbalances.
A case series of paediatric atrial myxoma: Clinical challenges and surgical management: Atrial Myxoma Septyandra, Ezi; Bermansyah; Nugraha, Aswin; Nova, Ria
Journal of Indonesia Vascular Access Vol. 4 No. 2 (2024): Available online : 1 December 2024
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v4i2.55

Abstract

Introduction : Cardiac myxomas are rare, benign tumors of the heart, most commonly found in the left atrium, though they can occur in any heart chamber. These tumors can embolize, causing organ infarction, and may present with symptoms such as dyspnea, orthopnea, cough, peripheral edema, palpitations, and fatigue. The clinical presentation varies widely and may mimic other diseases, making early detection and diagnosis critical. The reported incidence of cardiac myxoma at RS Mohammad Hoesin is 5 cases over 2023-2024, consisting of 3 pediatric cases and 2 adult cases. This report emphasizes the significance of thorough history taking, detailed physical examination, echocardiography, and surgical resection in managing atrial myxoma in two paediatric patients. Case Presentation : We reported three cases: a 16-year-old male, an 11-year-old female, and 12-year-old male, They were presenting with shortness of breath as the chief complaint. The male patient was diagnosed with decompensated heart failure due to a large left atrial myxoma, accompanied by tricuspid and pulmonary regurgitation, and underwent successful surgical removal of the myxoma. The female patient, with a history of contact with tuberculosis, was found to have a mass in the right atrium with a differential diagnosis of myxoma or tuberculoma. She was treated for clinical pulmonary tuberculosis and is currently under medical management. The last patient, male was diagnosed with a large left atrial myxoma, tricuspid regurgitation, and severe mitral regurgitation. The myxoma had removed from the left atrium in this patient. Conclusion : Paediatric atrial myxoma is a rare condition with a wide range of clinical manifestations, from asymptomatic cases to intracardiac obstruction, embolization, and constitutional symptoms. This often results in misdiagnosis as other more common heart diseases. Transthoracic echocardiography is useful as an initial diagnostic tool, as it effectively determines the tumor's location, size, shape, and connections, aiding in the selection of the optimal management strategy. Surgical excision is the primary treatment, with regular echocardiographic follow-up essential for the early detection of recurrence and long-term patient health.
Infective endocarditis: a case series Yazid, Keyshia Nur; Bermansyah; Satria, Gama; Umar, Ahmat; Nugraha, Aswin; Tobing, Arie Hasiholan Lumbang; Nasution, Indra Hakim
Journal of Indonesia Vascular Access Vol. 4 No. 2 (2024): Available online : 1 December 2024
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v4i2.56

Abstract

Introduction: Infective endocarditis (IE) remains a critical cardiovascular condition with significant mortality rates, ranging from 20% during hospitalization to 25-30% within six months post-infection. Valve abnormalities have been strongly associated with IE and worsen patient symptoms and prognostic. This study presents a case series of IE in Dr. Mohammad Hoesin Palembang Hospital. Case presentations: This case series reports on the management and outcomes of four pediatric patients treated for IE between January and May 2024 in RSUP Mohammad Hoesin Palembang. Each patient presents with moderate to severe mitral regurgitation and valve vegetation. Diagnoses were based on clinical symptoms and echocardiographic findings, adhering to the Duke criteria. The management involved systemic antibiotics and valve replacement surgery, with a focus on individualized treatment plans based on the severity of regurgitation and the presence of vegetation. Notably, all four patients survived and demonstrated substantial improvement in quality of life after surgical management. Conclusions: Our findings emphasize the efficacy of a multidisciplinary approach combining antibiotic therapy with timely surgical intervention for successful treatment outcomes in IE. Early diagnosis and appropriate management, including valve replacement, when necessary, are crucial for improving patient survival and quality of life.
Mechanical and bioprosthetic valves in young women: a systematic review and meta-analysis of cardiac, maternal, and fetal outcomes Harta, I Komang Adhi Parama; Pertiwi, Putu Febry Krisna; Yasa, Ketut Putu; Sudarma, I Wayan
Journal of Indonesia Vascular Access Vol. 4 No. 2 (2024): Available online : 1 December 2024
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v4i2.70

Abstract

Valve replacement for the heart in young women, particularly those who are pregnant, is challenging. It requires finding the right balance between valve durability, managing anticoagulation, and ensuring positive reproductive outcomes. This systematic review and meta-analysis compared mechanical prosthetic (MP) and bioprosthetic valves (BP) across cardiac, maternal, and fetal outcomes. Nine studies were included following a comprehensive literature search. The analysis revealed MACE involving MP and BP were not significantly different (OR: 1.31, 95% CI: 0.82–2.09, p = 0.26). Thromboembolic events were significantly more frequent in the MP group (OR: 6.59, 95% CI: 3.41–12.74, p < 0.001), while structural valve deterioration (SVD) occurred more often in BP recipients (OR: 0.01, 95% CI: 0.00–0.70, p = 0.03). Maternal outcomes showed a higher risk of pregnancy loss in MP recipients (OR: 4.62, 95% CI: 1.87–11.40, p < 0.001). Preterm delivery was more common went down in the MP group, but it wasn't enough to warrant statistical analysis (OR: 2.20, 95% CI: 0.86–5.58, p = 0.10). For reoperation or redo surgery, MP had lower risk and showed superior results than BP (OR: 0.06, 95% CI: 0.01–0.32, p = 0.001). These findings highlight the complexities involved in choosing between valve types. Although MP valves last longer, they increase the likelihood of thromboembolic events and miscarriage. While improving results for both the mother and the unborn child, BP valves, are prone to structural deterioration, necessitating reoperation. Individualized treatment decisions that consider patient preferences, clinical context, and reproductive plans are essential to optimizing outcomes for young women requiring valve replacement.

Page 4 of 6 | Total Record : 53

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