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"Latar belakang: Penyakit jantung bawaan (PJB) pirau kiri ke kanan adalah penyebab penting gagal tumbuh pada anak. Koreksi terhadap defek tersebut diketahui memperbaiki prognosis pertumbuhan berat maupun tinggi badan. Tujuan. Mengetahui korelasi usia koreksi defek dengan pertambahan tinggi badan pada pasien PJB pirau kiri ke kanan pasca-koreksi terhadap prognosis pertumbuhan. Metode: Penelitian dilakukan secara potong lintang dengan menggunakan rekam medis pada subyek dengan PJB pirau kiri ke kanan yang dikoreksi kurang dari 2 tahun di Rumah Sakit Cipto Mangunkusumo (RSCM) dengan variabel bebas usia koreksi defek dan variabel terikat z-skor dan Δz-skor TB/U pasca-koreksi. Referensi pertumbuhan menggunakan kurva WHO 2006. Perhitungan korelasi dilakukan menggunakan korelasi Spearman dan kemaknaan ditetapkan dengan p<0,05. Hasil: Median usia koreksi defek pada penelitian ini adalah 8 bulan dengan usia koreksi terbanyak adalah kurang dari 6 bulan dan usia 6-12 bulan masing-masing sebanyak 11 orang. Defek terbanyak adalah VSD. Usia koreksi defek tidak berkorelasi dengan z-skor TB/U pasca-koreksi berdasarkan uji korelasi Spearman (r= 0,093) dengan nilai p=0,642. Usia koreksi defek dengan Δ z-skor TB/U tidak ditemukan korelasi berdasarkan uji korelasi Spearman (r=0,143) dengan nilai p=0,452. Kesimpulan: Usia koreksi defek tidak terbukti berkorelasi baik dengan z-skor TB/U maupun Δ z-skor TB/U pasca-koreksi.

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Background: Congenital heart disease (CHD) left-to-right shunt is an important cause of growth failure in children. Correction of these abnormalities is known to improve the prognosis of growth in weight and height.

Objectives: Identify correlation between age of defect correction and height gain in patients with left-to-right shunt CHD after correction of growth prognosis Methods. This was a cross sectional study with reviewing medical records on subjects with CHD with left-to-right shunts who were corrected for less than 2 years at Cipto Mangunkusumo hospital with the independent variable being the age of defect correction and the dependent variable were z-score of post-correction height-for-age (H/A) and height gain (Δz-score H/A). The WHO 2006 growth chart were used as the growth reference. The correlation analysis was performed using the Spearman correlation and the significance was determined with p<0.05.

Results: The median age of defect correction in this study was 8 months. Most of the subjects were less than 6 months (11 subjects) and 6-12 months (11 subjects) in corrected ages. The most defects were ventricular septal defects (VSD). The age of defect correction did not correlate with the post-correction H/A z-score based on the Spearman correlation test (r= 0.093) with p value = 0.642 while the defect correction age with z-score H/A was not found to be correlated based on the Spearman correlation test (r = 0.143) with p value = 0.452.

Conclusion: The age of defect correction did not prove correlate with either the z-score for H/A or height gain."

"Latar Belakang: Infeksi menjadi masalah pada anak dengan penyakit jantung bawaan (PJB),terutama pneumonia. Faktor risiko yang mendasari perjalanan pneumonia pada anak adalah:usia, jenis kelamin, status gizi, pemberian ASI, berat lahir rendah, status imunisasi,pendidikan orangtua, status sosioekonomi, penggunaan fasilitas kesehatan. Insidenspneumonia pada anak dengan PJB pirau kiri ke kanan meningkatkan morbiditas danmortalitas.Tujuan: Mengetahui insidens pneumonia anak dengan PJB pirau kiri ke kanan dan faktorrisiko yang terkait.Metode: Penelitian ini adalah studi analitik dengan rancangan cohort retrospectiveberdasarkan penelusuran rekam medis di RSUPN dr. Cipto Mangunkusumo dari tahun 2015 -2019, Jakarta. Diagnosis PJB pirau kiri ke kanan berdasarkan echocardiography. Dari hasilyang ada, dilakukan analisis multivariat dan dilaporkan sebagai odds ratio (OR).Hasil: Dari 333 subyek dengan PJB pirau kiri ke kanan, 167 subyek mengalami pneumonia(50,2%). Proporsi jenis PJB pirau kiri ke kanan terbanyak yang menyebabkan pneumoniaadalah defek septum ventrikel (VSD), yaitu 41,9%. Defek ukuran besar berhubungan denganangka kejadian pneumonia (p=0,001). Faktor risiko yang mempengaruhi kejadian pneumoniapada anak dengan PJB pirau kiri ke kanan antara lain: status gizi buruk [OR 5,152 (95% CI2,363-11,234)], status imunisasi tidak lengkap [OR 9,689 (95% CI 4,322-21,721)], statussosioekonomi rendah [OR 4,724 (95% CI 2,003-11,138)], dan ukuran defek yang besar [OR5,463 (95% CI 1,949-15,307)].Simpulan: Insidens pneumonia pada anak dengan PJB pirau kiri ke kanan sebesar 50,2 %.Tipe PJB dengan insidens pneumonia terbanyak adalah VSD. Status gizi, imunisasi, statussosioekonomi dan ukuran besar defek mempengaruhi angka kejadian pneumonia."

"Latar belakang: Penyakit jantung bawaan (PJB) adalah kelainan kongenital dengan insidens tertinggi dan memerlukan pemantauan berkala. Pemeriksaan ekokardiografi memerlukan fasilitas dan tenaga ahli yang belum tersedia secara luas di Indonesia. Troponin I merupakan biomarker spesifik jantung yang terdeteksi pada awal terjadinya kerusakan miokardium. Data mengenai penggunaan biomarker jantung pada pasien anak dengan PJB masih terbatas.Tujuan: Mengetahui korelasi antara kadar troponin I dengan parameter hemodinamik pasien PJB asianotik dengan pirau kiri ke kanan.Metode: Penelitian ini merupakan studi potong lintang terhadap 53 subyek dengan PJB asianotik pirau kiri ke kanan yang berobat di Rumah Sakit dr. Cipto Mangunkusumo (RSCM). Pemeriksaan ekokardiografi dilakukan untuk menilai jenis PJB, ukuran defek, dan parameter hemodinamik yaitu Qp/Qs, tekanan sistolik arteri pulmoner, fraksi ejeksi ventrikel kiri, dan tricuspid annular plane systolic excursion (TAPSE). Kadar troponin I dinilai melalui enzyme linked fluorescent assay (ELISA) dengan sampel darah diambil pada hari yang sama dengan ekokardiografi..Hasil: Median usia subyek adalah 16 (3-135) bulan dengan jenis kelamin perempuan 54,7% (n=53). Diagnosis PJB terbanyak adalah ASD (45,3%), dengan proporsi terbanyak defek berukuran sedang (43,4%). Peningkatan kadar troponin I didapatkan pada 7 (13,2%) subyek. Tidak ada perbedaan bermakna kadar troponin I pada berbagai jenis PJB. Ada korelasi negatif lemah antara kadar troponin I dengan fraksi ejeksi ventrikel kiri (r=-0,391, p=0,002).Kesimpulan: Terdapat korelasi negatif lemah antara kadar troponin I dengan fraksi ejeksi ventrikel kiri, sementara tidak ada korelasi bermakna dengan parameter hemodinamik lainnya

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Background: Congenital heart disease (CHD) is the most frequent congenital abnormality and requires regular monitoring. Echocardiographic examination requires facilities and experts which are not widely available in Indonesia. Troponin I is a heart-specific biomarker that is detected early in myocardial damage. Data regarding the use of cardiac biomarker in pediatric CHD patients are still limited.

Objective: To determine the correlation between troponin I level and hemodynamic parameters in acyanotic CHD patients with left-to-right shunts.

Methods: A cross-sectional study of 53 subjects with left-to-right shunt acyanotic CHD as inpatient or outpatient at dr. Cipto Mangunkusumo (RSCM) Hospital. Echocardiography was performed to assess the type and size of CHD, as weel as hemodynanic parameters (Qp/Qs, pulmonary artery systolic pressure, left ventricular ejection fraction/EF, and tricuspid annular plane systolic excursion/TAPSE). Troponin I level was determined by enzyme linked fluorescent assay (ELISA) with blood samples taken on the same day as echocardiography.

Results: The median age of the subjects was 16 (3-135) months, with 54.7% female (n=53). Most prevalent of the CHD type was ASD (45.3%), most of the defect were medium-sized (43.4%). Increased troponin I levels were found in 7 (13.2%) subjects. There was no significant difference in troponin I level in various CHD types. There was a weak negative correlation between troponin I level and EF (r=-0.391, p=0.002).

Conclusion: There was a weak negatif correlation between troponin I level and EF, while there was no significant correlation with other hemodynamic parameters."

"Mortalitas pneumonia anak masih menjadi masalah kesehatan di seluruh dunia hingga saat ini. Bayi dengan penyakit jantung bawaan pirau kiri kanan (PJB L-R) berisiko menderita pneumonia. Data mortalitas pneumonia pada PJB L-R dan faktor-faktor yang memengaruhi belum banyak diketahui. Penelitian kohort retrospektif ini membandingkan mortalitas pneumonia dengan PJB L-R dengan tanpa PJB. Sebanyak 129 subyek dengan rentang usia 1 bulan - 7 tahun dengan diagnosis primer pneumonia, 54 subyek dengan PJB L-R dan 75 subyek tanpa PJB. Proporsi mortalitas pneumonia dengan PJB L-R lebih banyak (57,1%) dan risiko mortalitas lebih besar (OR 2,35; IK 95% 1,06 sampai 5,18) dibandingkan pneumonia tanpa PJB. Status gizi kurang/buruk, pneumonia rekuren, dan pneumonia terkait rumah sakit (HAP) lebih banyak secara signifikan pada pneumonia dengan PJB L-R. Sedangkan, tingkat keparahan dan anemia tidak berbeda bermakna di kedua kelompok. Pneumonia dengan tingkat keparahan berat memengaruhi mortalitas secara bermakna (OR 3,24; IK95% 1,16 sampai 9,08). Pneumonia rekuren, status gizi kurang/buruk, status imunisasi tidak lengkap, anemia, dan HAP tidak terbukti berhubungan dengan mortalitas pneumonia dengan PJB L-R.

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Childhood pneumonia is still a worldwide problem with high mortality. Infants with left to right shunt congenital heart disease (L-R CHD) are at risk of developing pneumonia. Pneumonias mortality in L-R CHD and its influencing factors are not well known. This retrospective cohort study analyzed mortality of pneumonia with L-R CHD with and without CHD. There were 129 subjects (age range of 1 month up to 7 years 11 months) with pneumonia as the primary diagnosis, consisting of 54 subjects with L-R CHD and 75 subjects without CHD. Mortality rate in children with L-R CHD was higher than those without CHD group (57.1%). The risk of mortality was greater (OR 2.35; 95% CI 1.06 to 5.18) compared to pneumonia without CHD. Moderate to severe malnutrition, recurrent pneumonia, and hospital acquired pneumonia (HAP) are significantly higher in L-R CHD group. Meanwhile, pneumonia severity and anemia were not significantly different in both groups. Severe pneumonia significantly affected mortality (OR 3.24; 95% CI 1.16 to 9.08). Recurrent pneumonia, moderate-to-severe malnutrition, incomplete immunization status, anemia, and HAP have not been proven to be associated with pneumonia mortality with L-R CHD."

"Pemberian air susu ibu ASI merupakan bentuk pemberian makanan yang paling disarankan untuk semua bayi, termasuk bayi dengan kebutuhan medis khusus seperti penyakit jantung bawaan. Penelitian ini bertujuan untuk memaparkan perilaku pemberian ASI pada 165 ibu yang memiliki bayi penderita penyakit jantung bawaan. Metode penelitian menggunakan survey deskriptif kuantitatif. Pengumpulan data menggunakan kuesioner pemberian ASI dan kuesioner perilaku pemberian ASI yang dimodifikasi dari penelitian Rickman 2017. Pemberian ASI eksklusif pada bayi penderita penyakit jantung bawaan hanya sebesar 36,4. Responden berusia 21-39 tahun tidak memberikan ASI eksklusif, begitupun dengan responden berpendidikan tinggi, tidak bekerja, berpendapatan cukup, multipara, dan berpengetahuan baik. Berdasarkan riwayat persalinan, responden yang melahirkan di fasilitas kesehatan, melahirkan secara sesar, melakukan inisiasi menyusu dini IMD. dan yang dirawat gabung tidak memberikan ASI eksklusif. Pada variabel dukungan sosial, responden yang mendapat dukungan suami dan ibu/mertua tidak memberikan ASI ekslusif. Sebanyak 62,2 bayi penderita kelainan asianotik dan 65,3 bayi penderita kelainan sianotik tidak mendapatkan ASI eksklusif. Kondisi medis bayi yang menyebabkan kendala menyusu pada bayi merupakan faktor utama tidak berhasilnya pemberian ASI eksklusif pada bayi penderita penyakit jantung bawaan. Hasil penelitian juga menunjukkan bahwa tenaga kesehatan kurang memberikan motivasi dan dukungan pada responden untuk memberikan ASI secara eksklusif. Hasil studi ini dapat menjadi informasi untuk menerapkan konseling ASI yang efektif dan tenaga kesehatan diharapkan mampu memberikan dukungan dan motivasi pada ibu untuk memberikan ASI secara eksklusif pada bayinya.

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Breastfeeding is the most recommended feeding for all infants, including infants with special medical needs such as congenital heart disease. This study aims to describe the breastfeeding behavior in 165 mothers who have infants with congenital heart disease. This research method used. quantitative descriptive survey. Data were collected using. modified breastfeeding and breastfeeding behavior questionnaire from Rickman 2017 study. Exclusive breastfeeding in infants with congenital heart disease is only 36.4. Respondents aged 21 39 years old did not provide exclusive breastfeeding, as did high educated, unemployed, fair income, multiparent, and knowledgeable respondents. Based on the history of labor, respondents who gave birth at. health facility, delivered by cesarean section, initiated breastfeeding, and who were treated together with their infants did not provide exclusive breastfeeding. In social support variables, respondents who have the support of husband and mother mother in law did not provide exclusive breastfeeding. As many as 62.2 of infants with asianotic abnormalities and 65.3 of infants with cyanotic abnormalities were not exclusively breastfed. The infant 39. medical condition that causes breastfeeding difficulties in infants is. major factor in the failure of exclusive breastfeeding in infants with congenital heart disease. The results also show that health workers less motivation and support to respondents to exclusively breastfeed. The results of this study can become an information to implement effective breastfeeding counseling and health workers are expected to provide support and motivation in mothers to exclusively breastfeed their babies. "

"Penyakit jantung bawaan dan abnormalitas jalan napas merupakan dua kondisi yang saling berkaitan dan dapat terjadi bersamaan. Terjadinya abnormalitas jalan napas pada pasien penyakit jantung bawaan dapat berpengaruh pada tata laksana serta prognosis pasien. Penelitian ini dilakukan secara retrospektif dengan melihata data dari rekam medis pasien penyakit jantung bawaan di RSCM tahun 2020–2022. Data yang diambil ialah usia, jenis kelamin, berat badan, diagnosis penyakit jantung bawaan, dan kondisi abnormalitas jalan napas. Data disajikan untuk melihat prevalensi abnormalitas jalan napas pada pasien penyakit jantung bawaan. Dari 69 subjek pasien penyakit jantung bawaan yang memenuhi kriteria inklusi, 15 atau 21,7% diantaranya memiliki abnormalitas jalan napas. Jenis penyakit jantung bawaan yang paling banyak ditemukan ialah Tetralogy of Fallot sebanyak 27 (39,1%) kasus. Jenis abnormalitas jalan napas yang paling banyak ditemukan ialah Laringomalasia sebanyak 9 (13%) kasus. Oleh karena itu, prevalensi abnormalitas jalan napas pada pasien penyakit jantung bawaan ialah sebesar 21,7%, dengan jenis abnormalitas jalan napas terbanyak ialah laringomalasia sebesar 13%. Terjadinya abnormalitas jalan napas pada pasien penyakit jantung bawaan memerlukan perhatian khusus dalam penanganan pasien. 

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Congenital heart disease and airway abnormalities are two related conditions that can occur together. The occurrence of airway abnormalities in patients with congenital heart disease can affect patient management and prognosis. The research was conducted retrospectively by looking at data from medical records of congenital heart disease patients at RSCM from 2020–2022. The data collected were age, gender, weight, diagnosis of congenital heart disease, and airway abnormality conditions. The data was presented to see the prevalence of airway abnormalities in patients with congenital heart disease. From 69 subjects of congenital heart disease patients who met the inclusion criteria, 15 or 21.7% of them had airway abnormalities. The most commonly found type of congenital heart disease was Tetralogy of Fallot, with 27 (39.1%) cases. The most commonly found type of airway abnormality was Laryngomalacia, with 9 (13%) cases. Therefore, the prevalence of airway abnormalities in patients with congenital heart disease is 21.7%, with the most common type of airway abnormality being Laryngomalacia at 13%. The occurrence of airway abnormalities in patients with congenital heart disease requires special attention in patient management."

"ABSTRAKPenyakit jantung bawaan (PJB) mengakibatkan morbiditas yang signifikan pada anak dan merupakan penyebab kematian utama dari antara kelainan kongenital lainnya. Usaha preventif PJB dengan cara identifikasi faktor risiko maternal diharapkan dapat menurunkan morbiditas dan mortalitas PJB.Tujuan. Penelitian ini bertujuan untuk mengetahui: (1) karakteristik (usia saat pertama kali terdiagnosis, jenis kelamin, status gizi, dan status ekonomi keluarga) penderita PJB anak di Poliklinik Kardiologi Ilmu Kesehatan Anak (IKA) Rumah Sakit Cipto Mangunkusumo (RSCM), (2) faktor risiko maternal yang diperkirakan mempengaruhi terjadinya PJB pada anak, yaitu: merokok aktif dan pasif selama kehamilan, diabetes melitus, obesitas, infeksi rubela saat kehamilan, usia saat kehamilan, dan pendidikan.Metode. Penelitian kasus kontrol dengan consecutive sampling dilakukan di Poliklinik Kardiologi IKA RSCM pada bulan Januari-Maret 2014. Pemeriksaan klinis, ekokardiografi, dan wawancara dilakukan terhadap 68 subjek PJB (kelompok kasus) dan 68 subjek anak sehat (kelompok kontrol).Hasil. Jumlah subjek penelitian sebanyak 136 subjek, dengan perbandingan kasus:kontrol adalah 1:1. Median (rentang) usia subjek saat diagnosis PJB adalah 5,5 (0,5-180) bulan, sebesar 80,9% terdiagnosis saat berusia kurang dari 1 tahun. Sebagian besar subjek PJB adalah perempuan (57,4%), mengalami malnutrisi (51,5%), dengan 7,4% di antaranya merupakan gizi buruk, dan memiliki status ekonomi keluarga menengah ke bawah (76,5%). Defek PJB non sianotik terbanyak adalah defek septum ventrikel (44,1%) dan PJB sianotik terbanyak adalah Tetralogi Fallot (14,7%). Faktor risiko maternal yang terbukti berhubungan bermakna dengan PJB anak adalah tingkat pendidikan ibu yang rendah. Faktor risiko merokok aktif dan pasif saat kehamilan, obesitas, dan usia ibu saat kehamilan tidak terbukti berhubungan dengan PJB anak, sedangkan faktor diabetes melitus dan infeksi rubela saat kehamilan tidak dapat dianalisis pada penelitian ini.Simpulan. Median (rentang) usia subjek saat diagnosis PJB adalah 5,5 (0,5-180) bulan, sebagian besar subjek terdiagnosis saat berusia kurang dari 1 tahun (80,9%). Sebagian besar subjek PJB adalah perempuan (57,4%), mengalami malnutrisi (51,5%), dan 7,4% di antaranya merupakan gizi buruk, dengan status ekonomi keluarga menengah ke bawah (76,5%). Faktor risiko maternal yang terbukti berhubungan bermakna dengan PJB anak adalah tingkat pendidikan ibu yang rendah.

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ABSTRACTCongenital heart defects (CHD) cause significant morbidities and are the leading cause of death among other congenital anomalies. Preventive measures with identification of maternal risk factors are expected to decrease morbidity and mortality rate in children due to CHD.Objectives. This study aimed to define: (1) characteristics (age at diagnosis, gender, nutritional status, and family’s economy status) of CHD patients in Pediatric Cardiology Clinic Cipto Mangunkusumo Hospital (CMH), (2) maternal risk factors that may influence CHD in children, namely: active and passive smoking in pregnancy, diabetes mellitus, obesity, rubella infection in pregnancy, age at pregnancy, and education.Method. Case-control study with consecutive sampling was performed in Pediatric Cardiology Clinic CMH in January-March 2014. Clinical examination, echocardiography, and interview were performed in 68 CHD subjects (case group) and 68 healthy subjects (control group).Results. Total subject in this study was 136, with ratio of case:control is 1:1. Median (range) of subject’s age at diagnosis was 5.5 (0.5-180) months, and 80.9% were diagnosed in the first year of age. Most of the subjects were female (57.4%), were malnourished (51.5%) with 7.4% were severe malnourished, and were from middle to low income family (76.5%). The most prevalent non cyanotic CHD was ventricle septal defect (44.1%), and the most prevalent cyanotic CHD was Tetralogy of Fallot (14.7%). Maternal risk factor that was significantly associated with CHD was low maternal education. Active and passive smoking in pregnancy, obesity, and maternal age at pregnancy were not associated with CHD, whereas diabetes mellitus and rubella infection in pregnancy could not be analyzed in this study.Conclusion. Median (range) of subject’s age at diagnosis was 5.5 (0.5-180) months, and mostly were diagnosed in the first year of age (80.9%). Most of the subjects were female (57.4%), were malnourished (51.5%) with 7.4% were severe malnourished, and were from middle to low income family (76.5%). Maternal risk factor that was significantly associated with CHD was low maternal education."

"[ASTRAKLatar Belakang: Pengetahuan seseorang yang tidak memadai terhadap risiko suatu tindakan medis berpotensi menimbulkan kecemasan dan tuntutan sehingga diperlukan upaya komunikasi dan pemberian edukasi dengan baik. Pembedahan penyakit jantung bawaan (PJB) anak berisiko tinggi terjadi morbiditas hingga mortalitas. Terdapat kesan pemahaman ibu yang tidak optimal terhadap pembedahan PJB anak mereka. Penelitian ini bertujuan untuk menilai pengetahuan ibu terhadap pembedahan PJB.Metode: Penelitian ini menggunakan uji eksperimen tidak murni (kuasi eksperimen) untuk mengetahui perubahan pengetahuan dan uji potong lintang untuk mengetahui proporsi pengetahuan yang rendah sebelum diberikan edukasi pada ibu anak yang akan menjalani pembedahan jantung pada bulan Mei hingga Juli 2014 di Instalasi Pelayanan Jantung Terpadu (PJT) RSUPNCM. Pengetahuan ibu dinilai menggunakan kuesioner dan edukasi menggunakan media edukasi mini flipchart. Kuesioner dan media edukasi dikembangkan sendiri oleh peneliti. Pengetahuan akan dinilai saat praedukasi dan pascaedukasi.Hasil: Sebanyak 57 subyek diikutsertakan dalam penelitian dan tidak ada subyek yang dikeluarkan saat penelitian. Analisis menggunakan stratifikasi untuk tiap diagnosis dan jenjang pendidikan. Total 47 subyek yang dapat dianalisis. Didapatkan 49% subyek memiliki pengetahuan rendah praedukasi dan seluruh subyek (100%) mengalami peningkatan pengetahuan pascaedukasi.Simpulan: Pemberian edukasi mampu meningkatkan pengetahuan ibu anak dengan PJB yang akan menjalani pembedahan jantung.

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ABSTRACTBackground : Inadequate knowledge about risk of upcoming medical intervention may raiseanxiety and demands. Therefore good communication and education are required. CongenitalHeart Disease (CHD) children surgery has high risk of morbidity and mortality. There is animpression that the mother has lack understanding of their children?s surgery. This studyaimed to assess the mother?s knowledge of CHD surgery.Method : This study used quasi-experimental design to determine changes in maternalknowledge and cross-sectional tests to assess the proportion of low knowledge prior theprovision of education on the mothers whose children underwent heart surgery in May to July2014 in RSUPNCM. Knowledge of mothers was assessed using questionnaires before andafter the education. Education was provided using ?mini flipchart? media. Questionnaires andeducational media were developed by the researchers.Result : A total of 57 subjects were included in the study and no subjects were excludedduring the research. Analysis was done by using stratification for each diagnosis. A total of47 subjects can be analyzed. We found that 49% of the subjects had low knowledge prior theprovision of education and all subjects (100%) had increasing knowledge after education.Conclusion : The provision of education is able to increase the knowledge of mothers whosechildren will undergo congenital heart disease surgery.;Background : Inadequate knowledge about risk of upcoming medical intervention may raiseanxiety and demands. Therefore good communication and education are required. CongenitalHeart Disease (CHD) children surgery has high risk of morbidity and mortality. There is animpression that the mother has lack understanding of their children’s surgery. This studyaimed to assess the mother’s knowledge of CHD surgery.Method : This study used quasi-experimental design to determine changes in maternalknowledge and cross-sectional tests to assess the proportion of low knowledge prior theprovision of education on the mothers whose children underwent heart surgery in May to July2014 in RSUPNCM. Knowledge of mothers was assessed using questionnaires before andafter the education. Education was provided using “mini flipchart” media. Questionnaires andeducational media were developed by the researchers.Result : A total of 57 subjects were included in the study and no subjects were excludedduring the research. Analysis was done by using stratification for each diagnosis. A total of47 subjects can be analyzed. We found that 49% of the subjects had low knowledge prior theprovision of education and all subjects (100%) had increasing knowledge after education.Conclusion : The provision of education is able to increase the knowledge of mothers whosechildren will undergo congenital heart disease surgery., Background : Inadequate knowledge about risk of upcoming medical intervention may raiseanxiety and demands. Therefore good communication and education are required. CongenitalHeart Disease (CHD) children surgery has high risk of morbidity and mortality. There is animpression that the mother has lack understanding of their children’s surgery. This studyaimed to assess the mother’s knowledge of CHD surgery.Method : This study used quasi-experimental design to determine changes in maternalknowledge and cross-sectional tests to assess the proportion of low knowledge prior theprovision of education on the mothers whose children underwent heart surgery in May to July2014 in RSUPNCM. Knowledge of mothers was assessed using questionnaires before andafter the education. Education was provided using “mini flipchart” media. Questionnaires andeducational media were developed by the researchers.Result : A total of 57 subjects were included in the study and no subjects were excludedduring the research. Analysis was done by using stratification for each diagnosis. A total of47 subjects can be analyzed. We found that 49% of the subjects had low knowledge prior theprovision of education and all subjects (100%) had increasing knowledge after education.Conclusion : The provision of education is able to increase the knowledge of mothers whosechildren will undergo congenital heart disease surgery.]"

"Latar Belakang: Penyakit jantung bawaan (PJB) dikoreksi dengan bedah jantung terbuka dengan bantuan alat mesin pintas jantung paru (cardiopulmonary bypass). Namun teknik ini dapat menyebabkan inflamasi pada paru yang menghasilkan kondisi Acute Respiration Dysfunction Syndrome (ARDS). Meskipun insidensinya pada pasien bedah dengan mesin pintas jantung paru hanya rendah, tingkat mortalitasnya dapat mencapai 50%. Tujuan: Mengetahui hubungan antara durasi penggunaan mesin jantung paru dengan insidensi ARDS pada pasien anak dengan PJB pasca bedah jantung terbuka. Metode: Studi kohort retrospektif dilakukan terhadap 194 anak yang menjalani bedah jantung terbuka atas indikasi PJB di Unit Pelayanan Jantung Terpadu (UPJT) RSCM periode Januari 2014-September 2015. Hasil: 64 (32,99%) pasien mengalami ARDS pasca bedah jantung terbuka dan sisanya sebanyak 130 (67,01%) tidak mengalami ARDS. Median penggunaan mesin pada golongan ARDS dan non-ARDS masing-masing sebesar 80 menit (23-219, IK90%) dan 70 menit (18-320, IK90%). Insidensi ARDS pada kelompok dengan durasi pendek (≤60 menit) adalah 27,5% dan dengan durasi panjang (> 60 menit) adalah 36%. Secara statistik dan klinis tidak terdapat hubungan bermakna antara durasi penggunaan mesin dengan munculnya ARDS (p = 0,298, uji chi square). Kesimpulan: Tidak terdapat hubungan bermakna antara durasi penggunaan mesin pintas jantung paru dengan kejadian ARDS pada pasien PJB pasca bedah jantung terbuka.

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Background: Congenital heart disease (CHD) is corrected by open thoracic surgery with the help of cardiopulmonary bypass machine (CPB). This technique can cause pulmonary inflammation resulting in Acute Respiratory Distress Syndrome (ARDS). Even though its incidence is low, the mortality rate of is up to 50%.

Aim: To find whether the duration of CPB using is related with incidence of ARDS in pediatric patients underwent open thoracic surgery.

Methods: Retrospective cohort study was done involving 194 pediatric patients underwent open thoracic surgery with CHD indication at Unit Pelayanan Jantung Terpadu (UPJT) RSCM within January 2014 and 2015 September.

Results: 64 (32,99%) patients had ARSD after open thoracic surgery. The mean of CPB machine duration was 80 minutes (23-219, CI90%) in patients with ARDS and 70 minutes (18-320, CI90%) in patients with no ARDS. The incidence of ARDS in patients with short duration of CPB (≤60 minutes) was 27.5% and long duration (>60 minutes) was 36%. There was no such correlation statistically and clinically between duration of CPB and ARDS occurence (p = 0.298, chi square test).

Conclusion: Duration of CPB using is not related with ARDS occurrence in pediatric patients with CHD underwent open thoracic surgery."

"Co-occurrence of cyanotic congenital heart disease (CCHD) and phaeochromocytoma (PCC) and paraganglioma (PGL) are rare, although some cases have been reported. We report a case of left paraganglioma in a 20-year-old lady with an underlying CCHD who underwent palliative Glenn shunt, subsequently developed polycythaemia and cavernous sinus thrombosis presented with palpitation, sweating, headache and hypertension of 3-months duration at the age of 17. The abdominal CT scan revealed an enhancing left paraaortic mass measuring 5.2 cm x 4.4 cm x 3.8 cm. A 24-hour urine catecholamine demonstrated raised noradrenaline level to six times upper limit of normal and hence diagnosis of left sympathetic (sPGL) was made. In view of the delayed diagnosis and significant morbidity associated with her condition, surgical treatment is no longer an option. Therefore, vigilant screening and early treatment of PCC-PGL in patients with CCHD are crucial in order to avoid significant morbidity and ensure a good quality of life."