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All Journal International Journal of Integrated Health Sciences Indonesian Journal of Cardiology
Aninka Saboe
Departemen Kardiologi Dan Kedokteran Vaskular, Universitas Padjadjaran
Health Professions Medicine & Pharmacology

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Infective Endocarditis with Multiple Valvar Vegetation in Uncorrected Tetralogy Fallot: A Case Report of Rare Condition Charlotte Johanna Cool; Eliza Techa Fattima; Mega Febrianora; Aninka Saboe
International Journal of Integrated Health Sciences Vol 9, No 2 (2021)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v9n2.2165

Abstract

Objective: To describe a case of an adult patient with uncorrected Tetralogy of Fallot (TOF) who suffered from Infective Endocarditis (IE) that involved the tricuspid and aortic valves.Methods: On October 2019, a-twenty-year-old male with uncorrected TOF was admitted to the emergency department of Dr. Hasan Sadikin General Hospital with a chief complaint of fever. The echocardiography showed the presence of vegetation on the tricuspid valve and aortic valve. The patient was given empirical antibiotics therapy for IE treatment. The serial blood cultures did not yield any organism growth and the transthoracic echocardiography evaluation showed healed vegetation after 21 days of antibiotics treatment.Results: A high turbulence in small VSD and valvular stenosis, as found in TOF, can injure the endocardial surface. While bacterial adherence to the injured endocardial surface can cause IE, no specific criteria available for diagnosing IE in congenital heart disease (CHD) patients compared to other population. In CHD patients, it is necessary to consider the diagnosis of IE presenting with signs of infection or fever. Our patient was known to have uncorrected TOF and was admitted to the hospital with a chief complaint of fever. The uncorrected TOF was complicated by an unusual form of aggressive vegetation involving multiple valves.Conclusion: The incidence of IE in uncorrected TOF is around 4%. Patient is  advised to receive a corrective surgery for the cardiac anomaly. Surgical repair of CHD with no residual lesion reduces the risk of IE.
Cardiac Cachexia dan Dampaknya terhadap Sintasan Penderita Gagal Jantung Aninka Saboe; Badai B. Tiksnadi; Augustine Purnomowati; Toni M. Aprami
Jurnal Kardiologi Indonesia Vol. 36, No. 2 April - Juni 2015
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v36i2.460

Abstract

Background. Cardiac cachexia (CC) is one of indicator of poor prognosis in heart failure. Unfortunately, its existence is often overlooked by many cardiologists, this is further complicated by small number of study concerning CC, and the controversial issues they encompasses.Methods. The aim of this study is to analyze the survival in heart failure (HF) patients with cachexia complications. A retrospective cohort study was conducted on the data from Hasan Sadikin General Hospital HF registry from March 2013 – August 2014. The inclusion criteria was the data registry (registry’s inclusion criterias: HF patients above 18 years of age with left ventricle ejection fraction (LVEF) below 40%, time onset of HF more than 6 months and exclusion criterias were valvular diseases as primary etiology of HF). The exclusion criteria was if the patients have other chronic disease (COPD, CKD, cancer). Cardiac cachexia was diagnosed in patients fulfilling the criteria from international cachexia consensus.Results. There were 39 patients, most of them were female (61.5%), with mean LVEF 28.5% (+6.7). Cardiac cachexia was diagnosed in 6 (15.3%) patients. At 6 months of follow-up after initial enrollment, the cumulative rate of death from cardiovascular cause was 83% among cachectic as compared 37.5% among noncachectic patients p=0.001 Adjusted HR (95%CI) = 8.05 (2.40–27.04). There were no association between mortality with sex (p=0.268), etiology of HF (p=0.288), LVEF (p=0.061), comorbid condition (hypertension p=0.237, diabetes mellitus p=0.163).Conclusions. We conclude that patients with cardiac cachexia is independent predictor of death in HF and warrants a special consideration in the management of HF.
Unexpected Infective Endocarditis in Corrected Congenital Heart Disease: A Case Report Charlotte Johanna Cool; Rachmi Serulina; Aninka Saboe
International Journal of Integrated Health Sciences Vol 10, No 1 (2022)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v10n1.2166

Abstract

Objective: To describe patients with corrected Congenital Heart Disease (CHD) who experienced Infective Endocarditis (IE).Methods: Two cases of IE were observed in 2019. The first case involved a 36-year-old woman with previous percutaneous transcatheter perimembranous ventricular septal defect (VSD) closure four months before admission. Echocardiography showed vegetation at noncoronary cusps of the aortic valve. Patient received antibiotics for six weeks and underwent surgery for evacuation of vegetation and device, along with VSD closure with a cardiovascular patch (Gore-tex). The second case involved a 43-year-old woman with a history of surgical closure in secundum atrial septal defect (ASD) by pericardial patch two months before admission. Echocardiography showed vegetation at the tricuspid valve. Patient received antibiotics for four weeks and planned for surgery to evacuate vegetation.  Results: IE is one of the major complications in CHD, whether uncorrected, treated, or corrected. The risk of IE increased with an invasive procedure. Post closure IE is rare. Poor dental hygiene and immunocompromised also increased patient's risk to be exposed to IE as shown in the first patient who had dental caries and the second patient who was on methylprednisolone for post-surgical pericardial effusion treatment. Conclusion: The risk of IE increases with invasive procedures in CHD patients. Although the incidence of IE is quite rare, its possibility should become of a serious concern among physicians.
Co-Authors Augustine Purnomowati Badai B. Tiksnadi Charlotte Johanna Cool Eliza Techa Fattima Mega Febrianora Rachmi Serulina Toni M. Aprami