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"This project represents a concise review of normal and abnormal cardiac anatomy and physiology, the evolution of SVR to EVLPP with validation of near normal ventricular restoration, plus act as a reference guide for cardiac surgeons with interest in SVR. The authors review normal and abnormal cardiac anatomy following post myocardial infarction and physiology, with focus on the evolution of surgical techniques aimed at establishing an ellipsoid ventricular shape, resulting in near-normal physiological hemodynamics evident at long term."

"Infark ventrikel kanan yang terutama terjadi sebagai komplikasi infark enitas penaykit tersendiri dimana dapat terjadi gangguan hemodinamik mayor."

"Infark ventrikel kanan yang terutama terjadi sebagai komplikasi infark inferior merupakan entitas penvakit tersendiri dimana dapat Jerjadi gangguan hemodinamik mayor, Pemeriksaan hemodinamik, elektrokardiografi (EKG), radionuklid angiografi dan ekokardio graft digunakan untuk mengetahui keterlibatan ventrikel kanan pada infark inferior. Infark ventrikel kanan terjadi pada 30 sampai 50% kasus infark inferior. Kami telah melakukan penelitian pada 37 pasien dengan infark inferior akut (dengan metode non invasif) dengan tujuan menilai peranan ekokardiogra.fi dalam diagnosis infark ventrikel kanan dan membandingkan aensitivitaxtiya terhadap EKG dan kriteria klinis. Pada ekokardiografi, 12 dari 37 pasien (32%) menunjukkan keterlibtitan ventrikel kanan. Tamla Kussmaul terjadi pada 27% pasien dan menunjukkan sensitivitas 50%, spesifisitas 88%, dan ketepatan prediksi 70%. Hantaran prekordial kanan pada EKG (V3R dan V4R) mendeteksi infark ventrikel kanan pada 30% pasien dengan sensitivitas, spesifisitas dan ketepatan prediksi masing-masing sebesar 67%, 88%, dan 73%. Gambaran ekokardiografi terdiri dari pembesaran ventrikel kanan dengan hipokinesia alau akinesia. Dilatasi dan disfungsi ventrikel kanan diperoleh dari besar relatif ventrikel kanan terhadap ventrikel kiri. Cara ini lebih sensitif dan spesifik dibandingkan gejala klinik dan EKG. (Med J Indones 2006; 15:94-9)

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Right ventricular myocardial infarction (RVMl) predominantly a complication of inferior wall myocardial infarction i.v a distinct clinical entity in which major hemodynamic disturbance may occur. Bedside hemodynamic measurement, electrocardiographs, gated blood pool radionuclide angiography and echocardiography are used to identify right ventricular involvement in setting of inferior wall infarction. RVMl as assessed by various diagnostic methods accompanies 30 to 50% of inferior wall infarction. We studied 37 consecutive patients of acute inferior wall infarction (by non invasive method) to determine echocardiographic evidence of RVMl and compared its sensitivity to electrocardiography and clinical criteria. On echocardiography 12 out of 37 patients (32%) had right ventricular involvement. Kussmaul's signs was present in 27% of the patients and it had sensitivity of 50%, specificity of 88% and predictive accuracy of 70%. Right sided precordial leads (VjR ~ V4R) on elect rocardiography showed evidence of RVMl in 30% of patients with sensitivity, specificity and predictive accuracy of 67%, 88% and 73% respectively. Echocardiographic features included enlargement of right ventricle and hypokinesia or akinesia of right ventricular wall. Right ventricular dilatation and dysfunction is gained from relative right and left ventricular dimension on echocardiography. it is more .sensitive and specific than clinical signs and ECG. (Med J Indones 2006; 15:94-9)"

"Ruptur septum ventrikel merupakan komplikasi mekanik yang jarang namun mengancam nyawa infark miokard akut. Operasi perbaikan ruptur merupakan tatalaksana utama. Bedah Pintas Arteri Koroner (BPAK) direkomendasikan untuk dlakukan secara konkomitan untuk revaskularisasi jantung. Penelitian ini bertujuan mengetahui hubungan antara tindakan konkomitan BPAK terhadap mortalitas pasca operasi perbaikan rupture septum ventrikel. Penelitian ini menggunakan metode studi potong lintang pada pasien terdiagnosis ruptur septum ventrikel pasca infark miokard yang menjalan operasi perbaikan ruptur dengan atau tanpa tindakan konkomitan BPAK di Unit Bedah Jantung Dewasa PJNHK sejak Januari 2018 hingga Desember 2023. Data yang diambil meliputi karakteristik pasien seperti umur, jenis kelamin, komorbiditas, fraksi ejeksi jantung kiri, status syok kardiogenik, dan lokasi ruptur septum ventrikel. Sebanyak tiga puluh empat pasien termasuk dalam kriteria penelitian. Tindakan konkomitan BPAK dilakukan pada 22 pasien (64,7%). Insidens kematian pasca operasi konkomitan BPAK lebih rendah dibandingkan kelompok pasien yang menjalani operasi perbaikan ruptur septum saja. Perhitungan multivariat menunjukkan bahwa operasi konkomitan BPAK memberikan efek protektif terhadap pasien pasca operasi (Adjusted OR 0,3, p = 0,167). Walaupun secara statistik tidak bermakna, fraksi ejeksi jantung kiri, status syok kardiogenik, dan lokasi ruptur septum ventrikel diasosiasikan dengan peningkatan mortalitas pasca operasi. Tindakan konkomitan BPAK diasosiasikan dengan mortalitas pasca operasi yang lebih rendah and memberikan efek protektif. Faktor preoperatif seperti fraksi ejeksi jantung kiri, status syok kardiogenik, dan lokasi rupture septum ventrikel memengaruhi mortalitas pasca operasi perbaikan septum ventrikel.

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Post-infarction ventricular septal rupture (VSR) is a rare life-threatening complication of acute myocardial infarction (AMI). Surgical repair of VSR remains the treatment of choice. Concomitant CABG is recommended as an additional procedure as a way of revascularization. This study aims to investigate the association between concomitant CABG and early post-operative mortality in post-infarction VSR undergoing surgical repair. This is a retrospective cohort study which includes patients who underwent VSR surgical repair with and without concomitant CABG at the Adult Cardiac Surgery Unit, National Cardiovascular Center Harapan Kita from January 2018 to December 2023. Preoperative factors include preoperative left ventricular ejection fraction (LVEF), cardiogenic shock, location of rupture and concomitant CABG surgery. Post operative outcomes recorded were early mortality which includes in-hospital and thirty-day mortality. A total of thirty-four subjects were included in this study with 22 patients (64.7%) undergoing concomitant CABG. Incidence of mortality in patients undergoing concomitant CABG is lower than patients without CABG. Adjusted OR showed a slight protective effect of CABG towards post-operative mortality (Adjusted OR 0.3, p = 0.167). Although it is not statistically significant, preoperative LEVEF, preoperative cardiogenic shock, and location of rupture are also associated with post-operative mortality. In conclusion, VSR surgical repair in concomitant with CABG showed lower post-operative mortality and protective effect while preoperative LVEF, cardiogenic shock, location of rupture are associated with post-operative mortality in patients undergoing VSR surgical repair."

"Beberapa penelitian terdahulu menunjukkan kontradiksi hubungan antara dispersi QT dengan kejadian takiaritmia ventrikel dan atau kematian jantung mendadak. Penelitian-penelitian itu tidak mengeluarkan pengguna obat penghambat reseptor beta, bahkan pengguna obat tersebut merupakan mayoritas pada sampel mereka. Karena penggunaan penghambat reseptor beta sebagai pencegahan sekunder yang masih rendah di Pusat Jantung Nasional Harapan Kita, maka penelitian ini dilakukan untuk mengetahui hubungan antara dispersi QT dengan kejadian takiaritmia ventrikel dan atau kematian jantung mendadak pada pasien pascainfark. Interval QT, dispersi QT dan variabel klinis dibandingkan antara 36 orang pasien pascainfark yang mengalami takiaritmia ventrikel dan atau kematian jantung mendadak (kelompok kasus), dengan 75 pasien pascainfark yang tidak mengalami kedua kejadian tersebut (kelompok kelola). Dispersi QT yang lebih panjang (115 + 41 msec vs 81 + 25 msec, p < 0.001). Interval QT maksimal terkoreksi juga lebih panjang pada kelompok kasus (534 + 56 vs 501 + 35 msec, p < 0.001). Analisa regresi logistik menunjukkan adanya hubungan antara pemanjangan dispersi QT dengan kejadian takiaritmia ventrikel dan atau kematian jantung mendadak dengan RO 3,2, 4, dan 5,8 masing-masing untuk nilai potong 80, 90, dan 100 mdet. Dispersi QT dapat memprediksi kejadian takiaritmia ventrikel dan atau kematian jantung mendadak pada pasien infark miokard akut. Hasil ini menunjukkan bahwa dispersi QT tetap bermanfaat pada kondisi bebas pengaruh obat penghambat reseptor beta. (Med J Indones 2005; 14: 230-6)

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Recent studies showed contradictive results of the relation between QT dispersion and the occurrence of ventricular tachyarrhythmias and/or sudden cardiac death. In addition, beta adrenoreceptors blocking agents, which are known to decrease the incidence of lethal arrhythmias after myocardial infarction, administered to the majority of patients in those studies population. Since b-blocker as secondary prevention drug was underutilized at National Cardiovascular Center Harapan Kita, this study was performed to find out the relation between QT dispersion and ventricular tachyarrhythmias and/or sudden cardiac death after previous myocardial infarction. The QT interval duration, QT dispersion and clinical variables of 36 postinfarction patients with history of sustained ventricular tachyarrhythmias and/or sudden cardiac death (event group) were compared with 75 postinfarction patients without such events (control group). QT dispersion differed significantly between study groups and was increased in the event group (115 ± 41 msec vs 81 ± 25 msec, p < 0.001). Corrected maximal QT interval duration was also prolonged in the event group (534±56 vs 501±35 msec, p < 0.001). Regression analysis showed that increasing QT dispersion was related to the occurrence of ventricular tachyarrhythmias and/or sudden cardiac death with OR of 3.2, 4, and 5.8 for cut-off point of 80, 90, and 100 msec respectively. The QT dispersion could predict the occurrence of ventricle tachyarrhythmias and/or sudden cardiac death in patient with AMI. This study confirmed that the QTd remain useful in free of beta blocking agents state. (Med J Indones 2005; 14: 230-6)"

"Latar Belakang: Pasien infark miokard akut (IMA) dengan hipertensi memiliki risiko yang lebih tinggi untuk terjadinya major adverse cardiac events (MACE). Pengukuran left ventricular mass index (LVMI) dengan ekokardiografi dapat membantu mengidentifikasi pasien IMA dengan hipertensi yang memiliki risiko untuk terjadinya MACE. Namun, penelitian mengenai hubungan antara LVMI dengan kejadian MACE pada pasien IMA dengan hipertensi pasca revaskularisasi perkutan belum ada di Indonesia.Tujuan: Mengetahui hubungan antara LVMI dan MACE pada pasien IMA dengan hipertensi pasca revaskularisasi perkutan.Metode: Penelitian ini merupakan studi kohort retrospektif di RSUPN Dr. Cipto Mangunkusumo dengan menggunakan data rekam medis pada periode tahun 2018–2022. Nilai LVMI didapatkan berdasarkan pemeriksaan ekokardiografi. Kejadian MACE dinilai pada saat perawatan Intensive Cardiology Care Unit (ICCU). Analisis menggunakan uji univariat, bivariat (chi-square), dan multivariat (regresi logistik) untuk melihat hubungan antara LVMI dan MACE pada pasien IMA dengan hipertensi pasca revaskularisasi perkutan.Hasil: Dari 160 pasien dengan IMA dan hipertensi yang menjalani revaskularisasi perkutan, terdapat 38 subjek (23,8%) yang mengalami MACE selama perawatan di ICCU. Dari 51,9% subjek dengan nilai LVMI meningkat, terdapat 34,9% yang mengalami MACE. Terdapat hubungan yang bermakna antara LVMI dan MACE dengan RR 2,99 (IK 95% 1,51-5,90) p 0,002). Pada analisis multivariat regresi logisitk, setelah memperhitungkan variabel perancu (usia dan penyakit ginjak kronik), LVMI secara independen terkait dengan peningkatan risiko kejadian MACE, dengan adjusted RR yang disesuaikan sebesar 2,869 (IK 95% 1,443–5,703) p 0,003.Kesimpulan: Terdapat hubungan yang bermakna antara LVMI dan MACE pada pasien IMA dengan hipertensi pasca revaskularisasi perkutan.

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Background: Patients with acute myocardial infarction (AMI) and hypertension have a higher risk of major adverse cardiac events (MACE) complications. Measuring the left ventricular mass index (LVMI) with echocardiography can help to identify AMI patients with hypertension who are at risk for MACE. However, study regarding the association between LVMI and MACE occurrence in patient with AMI and hypertension post-percutaneous coronary intervention (PCI) has not been conducted in Indonesia.

Objective: To determine the association between LVMI and MACE in patients with AMI and hypertension after PCI.

Methods: This is a retrospective cohort study at Dr. Cipto Mangunkusumo National General Hospital utilizing medical record data from the period of 2018 to 2022. The LVMI values were obtained based on echocardiographic examinations. MACE events were assessed during ICCU (Intensive Cardiology Care Unit) admission. The analysis utilized univariate, bivariate (chi-square), and multivariate (logistic regression) tests to examine the association between LVMI and MACE in patients with AMI and hypertension post-PCI.

Results: A total of 160 patients with AMI and hypertension undergoing PCI, 38 subjects (23.8%) experienced MACE during follow up in ICCU. Among 51,9% subjects with increased LVMI, 34.9% experienced MACE. There was a significant association between LVMI and MACE with a relative risk (RR) of 2,99 (95% CI 1,51–5,90, p 0,002). After adjustment for the confounders (age and chronic kidney disease) in a multivariate analysis logistic regression, LVMI was independently associated with risk for MACE with adjusted RR 2,869 (95% CI 1,443–5,703, p 0,003)

Conclusion: There was a significant association between LVMI and MACE in patients with AMI and hypertension who have undergone percutaneous revascularization."

"Approximately 120 different surgical procedures are used to correct congenital heart diseases, and the burden that this places on the surgeon is compounded by the exceptional complexity of the techniques and the rarity of many of the lesions. Training is problematic, not least because of legal issues, and currently available texts, drawings, and images are no substitute for real ‘live’ surgery.Against this background, the authors have set out to create an interactive multimedia manual that covers many aspects of congenital heart surgery. Each heart defect is addressed in an individual chapter, elaborating specific surgical anatomy and indication for surgery of heart defect first, followed by video clips depicting the operative approach and technique. The clips are accompanied by a clear descriptive narrative, and patient history and diagnostic images are available to provide a clear backdrop to the operation. "

"Indonesian Journal of Dentistry 2006; Edisi Khusus KPPIKG XIV: 120-123Congenital heart disease is a condition of heart anomaly found since birth. The most common is ventricular septal defect whereby an aperture is found in the partition of heart chamber. It is estimated that 40,000 newborn in Indonesia have this defective condition. Dental treatment for patient with such condition must be undertaken in a very cautious way. Tooth with multiple caries can potentially lead to endocarditis bacteria. As such, dentist must be watchful on dental treatment that may worsen the patient's condition. To prevent endocarditis bacteria, a prophylaxis antibiotic is required as recommended by the American Heart Association (AHA). In this particular case, a dental treatment was undertaken to a child patient with congenital heart disease. Previously, the patient has undergone dental treatment in the form of multiple extraction under general anesthesia before conducting cardiac surgery. ln this case the treatment includes mortal pulpotomy, GIC restoration, and fissure sealant - all conducted in one visit under general anesthesia. After a year after the treatment,here are no complaint from the patient and no irregularity in x-ray results."

"Latar Belakang. Terapi baku emas dalam penutupan defek septum ventrikel (DSV) adalah pembedahan. Prosedur pembedahan mempunyai morbiditas yang terkait dengan torakotomi, pintasan jantung paru, komplikasi prosedur, jaringan parut bekas operasi, dan trauma psikologis. Oleh karena itu, timbul usaha pendekatan transkateter untuk menutup DSV yang bersifat relatif kurang invasif. Tujuan. Mengetahui perbandingan hasil penutupan DSV perimembran, komplikasi prosedur, lama rawat di rumah sakit, dan total biaya prosedur antara prosedur transkateter dengan prosedur pembedahan. Metode. Penelitian retrospektif analitik dengan data berupa rekam medis pasien anak dengan DSV perimembran yang datang ke Pelayanan Jantung Terpadu Rumah Sakit dr. Cipto Mangunkusumo dan dilakukan penutupan defek dengan salah satu prosedur dalam periode Januari 2010-Desember 2013. Hasil. Sebanyak 69 kasus anak dengan DSV perimembran masuk dalam penelitian, terdiri dari 39 kasus dengan prosedur pembedahan dan 30 kasus dengan prosedur transkateter. Prosedur pembedahan dan prosedur transkateter mempunyai tingkat keberhasilan yang serupa (89,7% vs 96,7%, p=0,271). Prosedur pembedahan mempunyai komplikasi yang lebih banyak dibandingkan prosedur transkateter (46,7% vs 7,7%, p < 0,001). Prosedur pembedahan juga mempunyai lama rawat di rumah sakit yang lebih panjang dibandingkan prosedur transkateter (8 hari vs 3 hari, p<0,0001), dan semua prosedur pembedahan membutuhkan perawatan di ruang rawat intensif. Tidak ada perbedaan total biaya antara prosedur transkateter dengan prosedur pembedahan (Rp. 55.032.636 vs Rp. 58.593.320 p = 0,923). Simpulan. Prosedur penutupan DSV perimembran secara transkateter mempunyai efektivitas dan biaya yang sama dengan prosedur pembedahan dan mempunyai komplikasi yang lebih sedikit serta lama rawat di rumah sakit yang lebih pendek.

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Background. Surgery has become standard therapy for ventricular septal defect (VSD) closure, but it has significant morbidity related to sternotomy, cardiopulmonary bypass, complication, residual scar, and trauma. Non-surgical and less invasive approaches with transcatheter device were developed to occlude VSD.

Objectives. To compare efficacy, complication, length of hospital stay, and total cost of perimembran VSD closure procedure between transcatheter closure and surgery.

Methods. A retrospective analysis was performed on children with perimembran VSD admitted to Cardiology Center of Cipto Mangunkusumo Hospital from January 2010-December 2031. The patients received transcatheter closure or surgical closure. Data were obtained from medical record.

Results. A total of 69 perimembran VSD cases were included in study, consisted of 39 cases underwent transcatheter closure and 30 cases underwent surgical closure. The efficacy of both procedur were not statistically different (89.7% vs 96.7%, p=0.271). However, surgery procedure had more complication than transcatheter closure (46.7% vs 7.7%, p < 0.001). Hospital stay were also significantly longer for surgery procedure than transcatheter closure (8 days vs 3 days, p<0.0001), and all surgical subjects requiring intensive care. Transcatheter closure had median total cost Rp. 55.032.636 as compared with Rp. 58.593.320 for surgery procedure (p =0.923).

Conclusion. Perimembran VSD transcatheter closure had similar efficacy and costs with surgical closure. Complication rate was lower, and the length of hospital stay was shorter."