Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
Penggantian katup aorta dengan katup mekanik memerlukan biaya mahal, meningkatkan risiko endokarditis dan tromboemboli, serta memerlukan antikoagulan seumur hidup. Perikardium autolog merupakan alternatif untuk penggantian katup aorta. Tujuan penelitian ini adalah membandingkan luaran penggantian katup aorta antara katup mekanik dan perikardium autolog dengan teknik strip tunggal perikardium. Penelitian ini merupakan uji klinis terandomisasi di Pelayanan Jantung Terpadu Rumah Sakit Cipto Mangunkusumo (PJT-RSCM). Subjek dibagi ke dalam 2 kelompok berdasarkan jenis katup yang diterima, yaitu katup mekanik (kelompok mekanik) dan strip perikardium (kelompok strip). Luaran left ventricular reverse remodeling (LVRR), 6 minute walking test (6MWT), dan kadar soluble suppression of tumorigenicity-2 (sST-2) diperiksa preoperasi, 3 bulan, dan 6 bulan pascabedah. Terdapat 34 subjek yang ikut serta dari Juli 2016-Februari 2022, 17 subjek pada masing-masing kelompok. Tidak terdapat beda kejadian LVRR pada kedua kelompok, yaitu 26,7% pada kelompok mekanik dan 29,4% pada kelompok strip (p = 0,703). Pada pemeriksaan jarak 6 minute walking test (6MWT) tidak terdapat perbedaan bermakna jarak 6MWT antara kelompok strip perikardium dan kelompok mekanik pada 6 bulan pascabedah, yaitu 431,93 (SB 93,41) m vs. 404,28 (SB 79,25) m, p = 0,427 pascabedah. Kadar sST-2 kelompok mekanik 16,12 (SB 5,92) pg/mL secara bermakna lebih tinggi dibandingkan kelompok strip 11,52 (SB 6,96) pg/mL, p = 0,023) pada 6 bulan pascabedah. Disimpulkan teknik strip tunggal perikardium memiliki luaran yang sebanding dengan katup mekanik sehingga dapat digunakan sebagai alternatif penggantian katup aorta. ......Aortic valve replacement with mechanical valves are quite expensive, increased the risk of adverse events such as endocarditis and thromboembolism, and requires patients to take anticoagulants for the rest of their life. Autologous pericardium is an alternative for aortic valve replacement. This study aims to compare outcomes of aortic valve replacement using mechanical valve and prosthetic valve with single-strip pericardium technique. This was a randomized clinical trial conducted at the Cipto Mangunkusumo Hospital (PJT-RSCM). Eligible subjects were randomized to either receive mechanical valve (mechanical group) or single-strip pericardium (single-strip group). Outcome assessments of left ventricular reverse remodeling (LVRR), 6 minute walking test (6MWT), and soluble suppression of tumorogenicity-2 (sST-2) were carried out at preoperation, 3 months, and 6 months postoperation. There were 34 subjects recruited from July 2016 to February 2022, 17 subjects in each groups. There was no difference in postoperative LVRR incidence between both groups, 26.7% in mechanical group vs. 29.4% in single strip group (p = 0.703). There was no significant difference of 6MWT between the mechanical and pericardial strip at six months post-operation, 404.28 (SD 79.25) m vs. 431.93 (SD 93.41) m, p = 0.427. The sST-2 level is significantly higher in mechanical group 16.12 (SD 5.92) pg/mL compared to single strip group 11.52 (SD 6.96) pg/mL, p = 0.023 at six months post-operation. We concluded that single strip pericardium technique showed comparable outcomes to mechanical valve and is considered a feasible alternative for aortic valve replacement.

Abstrak :
The success of the first edition of Percutaneous treatment of left side cardiac valves has convinced us of the need to update this book in order to keep pace with the continuing rapid and dynamic evolution in the discipline. Once again, this practical guide is designed to provide the reader with complete state of the art information on the techniques and approaches to percutaneous treatment of left side cardiac valve disease. Numerous images will help the reader to understand in detail the steps of each procedure. The potential complications and expected or potential morbidity from each procedure are discussed in depth, and the best ways to manage them are carefully explained. The book is also intended as a reference covering the up-to-date knowledge contained in the literature on the application of transcatheter techniques to cardiac valves.