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Ganesja M. Harimurti
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Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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The role of transthoracal echocardiography in closing secundum atrial septal defects with Amplatzer Septal Occluder Harimurti, Ganesja M.; Munawar, Muhamad
Medical Journal of Indonesia Vol 16, No 1 (2007): January-March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (182.578 KB) | DOI: 10.13181/mji.v16i1.251

Abstract

Transesophageal echocardiography (TEE) under general anesthesia has become a routine procedure as guidance in implanting Amplatzer septal occluder (ASO) for closing secundum atrial septal defects (ASDs) together with fluoroscopy in cardiac catheterization laboratory. To simplify the procedure and reduce the cost, recently we used transthoracal echocardiography (TTE) in guiding the ASO implantation. Aim of this study is to evaluate accuracy and performance of ASO procedure guided by TTE compared to ASO procedure guided by TEE. This is a comparative study. Ninety-one patients with ASDs referred for transcatheter closure with ASO in National Cardiovascular Center Harapan Kita Hospital Jakarta were reviewed. In the 22 patients, TTE were used as guidance instead of TEE. Patients selection were performed in the outpatient clinic by TEE. The stretched diameter was measured by TEE or TTE and fluoroscopy. Patients were divided into two groups, TEE group consisted of procedures guided by TEE, and TTE group guided by TTE. From 91 patients, 83 can be evaluated. It consisted of 61 patients in TEE group and 22 in TTE group. Measurement of defects sizes with TTE and TEE have a high correlation with fluoroscopic measurements (r=0.837 and r=0.853, respectively). There were no significant differences between the accuracy of TTE and TEE sizes measurement (p=0.085) compared to fluoroscopy. Fluoroscopy time in ASO procedures guided by TEE was significantly longer than those guided by TTE (33.2 ± 21.3 min vs. 22.8 ± 19.3 min, P=0.014). There was also no significant differences in the failure of devices implantation between TEE and TTE guidance. All patients were in good condition at follow-up. ASO procedures guided by TTE have similar accuracy to those guided by TEE, with shorter fluoroscopy time. TTE guidance also has no difference in failure rate compared to TEE guidance. (Med J Indones 2007; 16:14-8) Keywords: amplatzer septal occluder, secundum atrial septal defect, transthoral echocardiography
Challenges in Diagnosis & Management of Type B Interrupted Aortic Arch Maruli Butarbutar; Ganesja M. Harimurti; Oktavia Lilyasari; Renan Sukmawan
eJournal Kedokteran Indonesia Vol. 10 No. 2 - Agustus 2022
Publisher : Faculty of Medicine Universitas Indonesia

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Abstract

Abstract Interrupted aortic arch (IAA) is a rare genetic disorder of the cardiovascular system, present in approximately 2 cases per 100,000 live births and comprising 1.5% of all cases of congenital heart disease (CHD). Its hallmark feature is a lack of luminal continuity between the ascending aorta and the descending aorta. In the absence of surgical repair, mortality approaches 75% in the first month of life and 90% by one year. A four months old female baby was referred with dyspnea, failure to thrive and recurrent respiratory infection. Physical examination revealed blood pressures and oxygen saturation were lower at upper right arm and both legs. The CXR examination revealed absent of aortic knob. The echocardiography showed aortic interruption between the left common carotid artery (LCCA) and left subclavian artery (LSCA). Cardiac MSCT showed LSCA and descending aorta come from PDA. The patient was managed with two stages surgery. Bilateral PA banding was done as first stage surgery. IAA repair and VSD closure are planned as second stage surgery.
Co-Authors Maruli Butarbutar Muhamad Munawar Oktavia Lilyasari Renan Sukmawan