Alice I. Supit
University of Sam Ratulangi Manado

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TETRALOGI FALLOT DAN ATRESIA PULMONAL Supit, Alice I.; Kaunang, Erling D.
Jurnal Biomedik : JBM Vol 4, No 3 (2012): JURNAL BIOMEDIK : JBM Suplemen
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.4.3.2012.1205

Abstract

Abstract: Congenital heart disease is a structural defect due to the malformation of the heart, aorta, and or great blood vessels. It is the most frequent congenital malformation in newborn babies. Tetralogy of Fallot is one of the congenital heart diseases (CHD) with central cyanosis, and covers 5-10% of all CHD. We reported a boy of one year old with Tetralogy of Fallot and pulmonal atresia (ToF-PA), associated with bronchopneumonia. The diagnosis was based on anamnesis, physical examination, and other supporting examinations. The chest X-ray showed a normal sized heart (CTR 57%) with coer-en-sabot shape, and right and left parahilar infiltration, which resulted in bronchopneumonia and ToF. The electrocardiography showed a right deviation of axis and a hypertrophy of the right ventricle; the echocardiography showed a right ventricle hypertrophy, an over-riding aorta, a large malalignment of the ventricular septal defect, no visualization of pulmonar artery, and no visualization of patent ductus arteriosus (PDA). Conclusion: Based on all the tests performed, the diagnosis of this patient was Tetralogy of Fallot and pulmonal atresia (ToF-PA), associated with bronchopneumonia. The prognosis related to bronchopneumonia in this case was good due to the use of antibiotics. Keywords: tetralogy of Fallot, pulmona atresia, bronchopneumonia.  Abstrak: Penyakit jantung bawaan (PJB) ialah kelainan struktural akibat malformasi jantung, aorta dan atau pembuluh darah besar, dan merupakan kelainan kongenital tersering pada bayi baru lahir. Tetralogi Fallot merupakan salah satu PJB dengan sianosis sentral, dan mencakup 5-10% dari seluruh PJB. Kami melaporkan kasus seorang anak laki-laki berusia satu tahun dengan Tetralogi Fallot dan atresia pulmonal (ToF-PA) disertai bronkopneumonia. Diagnosis ditegakkan melalui anamnesis, pemeriksaan fisik, dan pemeriksaan penunjang. Hasil ekspertisi foto toraks AP memperlihatkan ukuran jantung normal (CTR 57%) berbentuk coer-en-sabot, dan pada paru-paru terlihat infiltrat parahilar kanan dan kiri serta corakan vaskular paru berkurang yang menunjukkan suspek bronkopneumonia dan ToF. Elektrokardiografi memperlihatkan deviasi aksis ke kanan dan hipertrofi ventrikel kanan, dan pada ekokardiografi tampak right ventricle hypertrophy, overriding aorta, VSD malalignment besar, tidak tampak visualisasi arteri pulmonal, dan tidak tampak patent ductus arteriosus (PDA) dengan hasil Tetralogi Fallot dan atresia pulmonal. Simpulan: Berdasarkan hasil pemeriksaan yang dilakukan, diagnosis pasien ini ialah Tetralogi Fallot dan atresia pulmonal (ToF-PA) disertai bronkopneumonia. Prognosis bronkopenumonia pada kasus ini baik yang dapat diatasi dengan antibiotika.Kata kunci: tetralogi Fallot, atresia pulmonal, bronkopneumonia.  
CORRELATION BETWEEN ALLEN’S AND INVERSE ALLEN’S TESTS WITH DIAMETERS OF ULNAR AND RADIAL ARTERIES Supit, Alice I.; Budiono, Bambang; Lefrandt, Reginald L.
JURNAL BIOMEDIK : JBM Vol 5, No 2 (2013): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.5.2.2013.2590

Abstract

Abstrak: Arteri radialis semakin sering dipergunakan sebagai akses alternatif angiografi koroner dan intervensi karena dibanding akses femoralis, komplikasi perdarahan lebih rendah, mobilisasi lebih dini, dan biaya lebih murah. Terdapat beberapa hal yang dapat mengurangi keberhasilan prosedur ini; salah satunya ialah kegagalan pungsi karena ukuran a. radialis yang kecil. Studi sebelumnya menunjukkan bahwa uji Allen dapat digunakan untuk mendeteksi arteri dengan diameter yang lebih besar. Penelitian ini bertujuan untuk mengevaluasi apakah uji Allen dan inverse Allen berkorelasi dengan diameter a. ulnaris dan a. radialis. Penelitian ini berlangsung dari Juli hingga Desember 2012 di Laboratorium Kateterisasi Rumah Sakit Awal Bros Makassar. Pasien menjalani uji Allen dan inverse Allen sebelum prosedur. Ukuran diameter dalam dari lumen arteri radialis dan ulnaris diukur oleh operator dengan menggunakan analisis angiografi kuantitatif (operator tidak mengetahui hasil uji Allen). Uji Spearman?s rho digunakan untuk menganalisis korelasi antara uji Allen dan inverse Allen dengan diameter a. radialis dan a. ulnaris dengan P < 0,05 dianggap bermakna. Analisis statistik menggunakan SPSS versi 19. Hasil penelitian memperlihatkan 121 pasien (98 laki-laki dan 23 perempuan, rerata usia 57,5 (SD ± 11,9 tahun). Frekuensi crossover 3,3%. Uji Allen dan inverse Allen normal pada 116 pasien (95,8%). Rerata diameter a. radialis dan ulnaris ialah 2,14 (SD ± 0,34 mm) dan 1,95 (SD ± 0,45 mm). Uji korelasi Spearman?s rho menunjukkan korelasi bermakna antara uji Allen dan diameter a. ulnaris (P = 0,000; r = -0,485); uji inverse Allen dan diameter a. radialis (P = 0,015; r = -0,220). Simpulan: Terdapat korelasi bermakna antara uji Allen  dengan diameter a. ulnaris, dan uji inverse Allen dengan diameter a. radialis. Kedua uji ini sederhana dan dapat memberikan informasi tentang arteri mana memiliki diameter yang lebih besar. Bila uji Allen normal, maka a.ulnaris dapat dipergunakan sebagai akses alternatif ketika akses radialis gagal atau bahkan sebagai akses inisial jika uji inverse Allen abnormal atau waktu uji Allen lebih singkat dari inverse Allen, terutama untuk prosedur intervensi yang memerlukan arteri yang lebih besar sebagai akses. Kata kunci: uji Allen, uji inverse Allen, diameter, arteri radial, arteri ulnaris.   Abstract: Radial artery has been increasingly used as an alternative site for coronary angiography and intervention because of its advantages over femoral access, such as: a reduction in bleeding complications, early mobilisation, and lower cost. Despite these advantages, there are some challenges that reduce procedural success. One of them is the puncture failure owing to the small vessel size. A previous study has demonstrated consistently that the Allen test may be used for detecting the artery with the largest diameter. This study aimed to evaluate whether the Allen?s and inverse Allen?s tests correlate to the diameters of ulnar and radial arteries. This study was conducted from July to December 2012 in the Catheterization Laboratory of Awal Bros Hospital Makassar. Patients underwent the Allen?s and inverse Allen?s test before the procedure. The inner luminal diameters of radial and ulnar arteries were measured by an operator using quantitative angiographic analysis software. The operator was blinded to the results of the Allen?s tests. The Pearson correlation test was used to analyze the correlation between Allen?s and inverse Allen?s test with the diameters of the radial and ulnar arteries. A P-value of < 0.05 was considered as statistically significant. Statistical analysis was performed with Statistical Package for Social Sciences (SPSS) version 19. The results showed that there were 121 patients (98 males and 23 females, the mean age being 57.5 (SD ± 11.9 years). The crossover rate was 3.3%. Both of the Allen?s and inverse Allen?s tests were normal in 116 patients (95.8%). By using a quantitative coronary analysis software, the mean diameters of the radial and the ulnar arteries were  2.14 (SD ± 0.34 mm) and 1.95 (SD ± 0.45 mm), respectively. The Spearman?s rho correlation test showed significant correlations between the Allen?s test and diameters of ulnar arteries (P = 0.000; r = -0.485), and between the inverse Allen?s test and diameters of radial arteries (P = 0.015; r = -0.220). Conclusion: The Allen?s test correlated to the diameters of the ulnar arteries and the inverse Allen?s test correlated to the diameters of the radial arteries. The normal Allen?s test indicated that the ulnar artery might be used as an alternative access site when the radial approach failed or even as an initial access if the inverse Allen?s test was abnormal or the Allen?s test was shorter than the inverse Allen?s test, especially for the intervention procedure which needed a larger artery as the access site. These tests are simple and may provide some important information about arteries with larger diameters. Future studies with larger series of patients will be necessary to confirm our results. Keywords: Allen?s test, inverse Allen?s test, diameter, radial artery, ulnar artery.
Dampak Coronavirus Disease 2019 terhadap Sistem Kardiovaskular Willim, Herick A.; Ketaren, Infan; Supit, Alice I.
e-CliniC Vol 8, No 2 (2020): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v8i2.30540

Abstract

Abstract: Coronavirus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection has become a pandemic. Patient with cardiovascular comorbidity has a higher risk of suffering more severe manifestation of COVID-19 associated with a higher mortality. Although dominated by respiratory clinical manifestation, COVID-19 may also cause severe cardiovascular disorders. Angiotensin converting enzyme 2 (ACE2) acts as a receptor of SARS-CoV-2. Patients of COVID-19 with cardiovascular comorbidities may experience more severe clinical manifestations, presumably due to higher ACE2 expression in this population. Cardiovascular complications in COVID-19 may include myocardial injury, myocarditis, acute myocardial infarction, acute heart failure, thromboembolism, and arrhythmias. Therefore, optimization of conservative medical therapy needs to be prioritized in patients with cardiovascular comorbidities. Emergency intervention can be considered in certain cases with hemodynamic instability.Keywords: cardiovascular system, COVID-19, SARS-CoV-2, ACE2 Abstrak: Coronavirus disease 2019 (COVID-19) telah merupakan pandemi yang disebabkan oleh infeksi Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Pasien dengan komorbid kardiovaskular berisiko lebih tinggi untuk mengalami manifestasi yang lebih berat jika terinfeksi COVID-19 dan berhubungan dengan mortalitas yang lebih tinggi. Meskipun didominasi oleh manifestasi klinis respiratorik, COVID-19 juga dapat menyebabkan gangguan kardiovaskular yang berat. Angiotensin converting enzyme 2 (ACE2) berperan sebagai reseptor SARS-CoV-2. Diduga pasien dengan penyakit kardiovaskular dapat bermanifestasi klinis lebih berat karena ekspresi ACE2 yang lebih tinggi pada populasi ini. Komplikasi kardiovaskular pada COVID-19 dapat meliputi jejas miokardium, miokarditis, infark miokard akut, gagal jantung akut, tromboemboli, dan aritmia. Pada pasien dengan komorbid kardiovaskular, optimalisasi terapi medis konservatif perlu diprioritaskan. Tindakan intervensi darurat dapat dipertimbangkan pada kasus tertentu dengan instabilitas hemodinamik.Kata kunci: sistem kardiovaskular, COVID-19, SARS-CoV-2, ACE2