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All Journal Indonesian Journal of Cardiology Jurnal ARSI (Administrasi Rumah Sakit Indonesia)
Indriwanto Sakidjan
Departement Cardiology And Vascular Medicine Faculty Of Medicine, Universitas Indonesia/National Cardiac Center Harapan Kita
Decision Sciences, Operations Research & Management Health Professions Medicine & Pharmacology Public Health Social Sciences

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Faktor-Faktor yang Mempengaruhi Perubahan Resistensi Vaskular Pulmonal segera Pasca Komisurotomi Mitral Transvena Perkutan pada Stenosis Mitral Adi Purnawarman; Nur Haryono; Indriwanto Sakijan
Jurnal Kardiologi Indonesia Vol. 32, No. 3 Juli - September 2011
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v32i3.94

Abstract

Background. In mitral stenosis (MS) patients, the increase in pulmonary arterial pressure and severity of the clinical symptom is not always related to the severity mitral valve stenosis and mitral valve gradient, but the pulmonary vascular resistance (PVR) as well. Methods. It’s a cross sectional study. PVR is measurement with invasive procedure before and immediately after the Balloon Mitral Valvotomy (BMV) procedure. The analysis was performed to assess the correlation of the age, gender, mitral valve area (MVA), mitral valve gradient (MVG), systolic pulmonary artery preasure (sPAP), mean pulmonary artery preasure (mPAP), mean left atrial preasure (mLAP), mitral score and improvement of the PVR immediately after BMV procedure.Results. There were 136 patients with mitral stenosis in the period 2008 Jan – 2010 Oct. Seventy five subjects (55.1%) had a atrial fibrilation (AF), 4 subjects (2.9%) complicated with severe aortic stenosis and 2 (1.4%) moderate to severe mitral regurgitation. Of 29 subjects eligible, 65.5% were women with age of 34 (19-53) years. After BMV, MVA increase from 0.5 (0.2 -1.3) to 1.0 (0.3 to 2.4) cm2 (p <0.001), MVG decreased from 19.0 (4 -29) to 7,0 (2 -10) mmHg (p <0.001), cardiac output increased from 2.8 (1.7 to 4.6) to 3.2 (2 -6) L (p <0.001), mPAP decreased from 56.1 ± 12,1 to 41.4 ± 9.8 mmHg (p <0.001), sPAP decreased from 87 (28-110) to 69 (18-110) mmHg (p <0.001), mLAP decreased 28.9 ± 8.0 to 16.0 ± 6.8 mmHg (p <0.001) and PVR decreased from 9.0 (6.3 to 17.8) to 7.8 (2.6 to 14.3) (P <0.001) immediately after the procedure. MVA pre procedure was significant different between subject with and without PVR reduction below 6WU (0.6[0.4-1.3] vs 0.4[0.2-0.7], p=0.024). Logistic regression analysis showed MVA was a predictor of PVR reduction immediately after procedure (OR 0,003 with p value 0,04 and 95% C.I. 0,0001 – 0,766).Conclusion. The pre-procedure MVA is a predictor of PVR reduction immediately after BMV procedure.
Korelasi Antara Durasi QRS, Fungsi Ventrikel Kanan dan Disinkroni Ventrikel Kiri Pasca Koreksi Tetralogi Fallot Retna Dewayani; Bambang Budi Siswanto; Poppy S Roebiono; Anna Ulfah Rahajoe; Indriwanto Sakidjan; Ganesja M Harimurti
Jurnal Kardiologi Indonesia Vol. 28, No. 4 Juli 2007
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v28i4.229

Abstract

Background. QRS duration has long been established as a strong predic-tor of sudden cardiac death in patients after surgical correction of Tetral-ogy of Fallot (TOF). Several factors has been correlated to QRS duration, i.e severity of pulmonal regurgitation and right ventricular volume after TOF correction. But there is no established relation between right ven-tricular function and QRS duration after surgical correction TOF.Objectives. We aimed to investigate the relation between QRS duration and right ventricular function and whether patients after TOF repair with right bundle branch block have left ventricular dissynchrony.Methods.50 patients with repaired TOF were studied. Right ventricular function were derived from tissue Doppler imaging Tei index. Left ven-tricular dissynchrony were derived from tissue Doppler imaging. The time interval between the onset of QRS complex and the onset of systolic ejec-tion was measured for six left ventricular basal wall, i.e septal, lateral, anteroseptal, posterior, anterior and inferior wall. Mechanical delay from septal to lateral wall, antero-septal to posterior wall and anterior to infe-rior wall was calculated. Measured data were correlated with QRS dura-tion.Results.There was relation between QRS duration and right ventricular function (P = 0.028, r = 0.44). Ten (20%) of the examined patients after TOF repair had LV dissnynchrony particularly in patients with RBBB and prolonged QRS duration (160 ± 9 ms).Conclusions.There is correlation between right ventricular function and QRS duration. Left ventricular dissynchrony may exist in patients after TOF repair with RBBB.
Giant Coronary Artery Aneurysms in Kawasaki Disease Detected by Multi Detector Computed Tomographic Oktavia Lilyasari; Poppy S Roebiono; Radityo Prakoso; Anna Ulfah Rahajoe; Indriwanto Sakidjan; Ganesja M Harimurti
Jurnal Kardiologi Indonesia Vol. 34, No. 2 April - Juni 2013
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v34i2.331

Abstract

Kawasaki disease is an acute, self -limited vasculitis of unknown etiology that occurs predominantly in infants and young children. The major sequele of Kawasaki disease are related to the coronary arterial system. Cardiac imaging is a critical part in evaluation of all patients with suspected Kawasaki disease. Multi Detector CT (MDCT) provides a safe non-invasive approach to accurately delineate coronary artery anatomic structure. We report a case of a 6 years old boy with history of Kawasaki disease. Multi detector CT scan showed giant aneurysm at proximal LAD, proximal RCA and medium aneurysm at proximal LCX. Patient then treated with the anticoagulant therapy.
Pengaruh Tingkat Keparahan Stenosis Mitral Terhadap Kadar Soluble Vascular Cell Adhesion Molecule-1 dan Soluble Intercellular Adhesion Molecule-1 Pramono Sigit; Yoga Yuniadi; Indriwanto Sakidjan
Jurnal Kardiologi Indonesia Vol. 35, No. 1 Januari - Maret 2014
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v35i1.371

Abstract

Background: Blood Soluble Vascular Cell Adhesion Molecule-1 (sVCAM-1) and Soluble Intercellular Adhesion Molecule-1 (sICAM-1) levels are increased in Mitral Stenosis (MS) patients, but whether this phenomenon is due to chronic rheumatic inflammation process or because of hemodynamic effect of mitral stenosis severity is not clear yet.Objective: This research aims to study the effect of mitral stenosis severity on blood sVCAM-1 and sICAM-1 levels.Method: This study is a cross sectional study. Research subjects were divided into 3 groups: control patients, pre BMV (Baloon Mitral Valvulotomy) group, and post BMV group (patients who have already undergone BMV for ? 1year). Blood sVCAM-1 and sICAM-1 were measured using quantitative sandwich immunoassay method in all groups, and echocardiographic study to evaluate MS severity (MVA (Mitral Valve Area), mMVG (mean Mitral Valve gradient), TVG (Tricuspid Valve Gradient), mPAP (mean Pulmonary Artery Pressure), and LAVI (Left Atrial Volume Index) were performed to pre BMV and post BMV group at the same day with the blood sample collections.Results: There were 23 normal subjects, 26 patients in pre BMV group, and 27 patients in post BMV group. The sVCAM-1 and sICAM-1 levels in patients with MS (pre BMV and post BMV group) were higher than normal control subjects (536,87 ± 251,68 ng/ml vs 536,87 ± 149,22 ng/ml; p<0,001 and 270,04 ± 111,67 ng/ml vs 216,43 ± 50,60 ng/ml; p=0,006), meanwhile there were no differences of sVCAM-1 and sICAM-1 levels between pre BMV and post BMV group (854,67 ± 227,26 ng/ml vs 809,22 ± 275,63 ng/ml; p=0,515 dan 279,98 ± 114,39 ng/ml vs 260,49 ± 110,38 ng/ml; p=0,539). There were also no significant correlation between mitral stenosis severity (MVA, mMVG, TVG, mPAP dan LAVI) with sVCAM-1 and sICAM-1 levels (p>0,05).Conclusion: There were no correlation between mitral stenosis severity with blood sVCAM-1 and sICAM-1 levels
Preoperative and predischarge predictors for persistent pulmonary hypertension after mitral valve surgery in patients with chronic organic mitral regurgitation Rina Ariani; Indriwanto Sakidjan; Budhi Setianto
Jurnal Kardiologi Indonesia Vol. 35, No. 2 April - Juni 2014
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v35i2.394

Abstract

Objectives. This study sought to evaluate the prevalence of pulmonary hypertension after mitral valve surgery ini patients with chronic organic mitral regurgitation and to determine preoperative and predischarge predictors for persistent pulmonary hypertension after surgeryMethods. This is a cohort retrospective study involving subjects with chronic organic mitral regurgitation with preoperative systolic PA pressure > 50 mmHg undergoing surgery. Demographic and echocardiography datas were collected prior to surgery, predischarge, and follow up datas were evaluated after minimal 6 months duration. Subjects were then devided into groups based on existence of persistent pulmonary hypertension after follow up. Bivariate and multivariate analysis was done to determine contributing factors.Results.There were 92 subjects with dominant mitral regurgitation included in this study with median age 40 (range 17-68) years with slight female predominance (55%). Persistent pulmonary hypertension was observed in 23 subjects (25%) predischarge and in 20 subjects (20.7%) after mean follow up of 11 + 5.5 months. Bivariate analysis revealed preoperative TAPSE, underlying etiology, severity of pulmonary hypertension preoperatively, postoperative atrial fibrilation, mean mitral valve gradient predischarge, and the presence of residual pulmonary hypertension predischarge were related with persistent pulmonary hypertension. From multivariate analysis, post operative atrial fibrillation [OR 7.3 (CI 95% 1.64-33.33, p=0.09)], mean mitral valve gradient predischarge [OR 1.67 (CI 95% 1,3-2.7, p=0.038)], and preoperative TAPSE [OR 0.143 (CI 95% 0.03-0.70, p=0.017)] were independent predictors for persistent pulmonary hypertension after mitral valve surgery.Conclusion. Persistent pulmonary hypertension was observed in 20.7% subjects after mitral valve surgery. Preoperative TAPSE, post operative atrial fibrillation, and predischarge mean mitral valve gradient were independent predictors.
Peranan Mitral Leaflet Separation Index (Mlsi ) dalam Menentukan Severitas Stenosis Mitral I Made Junior Rina Artha; Amiliana M Soesanto; Indriwanto Sakidjan; Ganesja M Harimurti
Jurnal Kardiologi Indonesia Vol. 36, No. 4 Oktober - Desember 2015
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v36i4.501

Abstract

Objective. To Correlate MLSI with 3-D mitral valve area (MVA) planimetry in determining mitral stenosis (MS) severity.Background. Mitral Stenosis (MS) is still a major problem in cardiology, and causes of morbidity dan mortality worldwide. Echocardiogrphy plays an important role in assessing mitral stenosis severity. Mitral leaflet separation index (MLSI) is one of simple method that can be used in peripheral by using common ultrasound to assess the severity mitral stenosis.Methods. We employed a cross sectional study. Mitral stenosis patients who referred for evaluation echocardiography in National Cardiac Center Harapan Kita from April to September 2011. MLSI was obtained by averaging the maximal leaflet separation distance at the tips in diastole in parasternal long-axis and apical four- chamber views. 3-Dimensional (3-D) mitral valve area (MVA) planimetry as a reference. The only exclusion criteria was severe calcification and poor echo window. Echocardiography examination using Philips E33i.Results. Seventy six consecutive patients were enrolled, 5 subjects were excluded from study because of severe calcification and poor echo window. Proportion of woman is 73.2 % and mostly in age group < 40 years old (43.7 %). Severe mitral stenosis was dominate the subject, 47 subject (66.2 %), moderate was 19 subject (26.8 %), and mild only 5 subjects (7.0 %). Analysis with Spearman correlations obtained a good correlation with r = 0.70, p < 0.001, good correlation was found in sinus rhythm with r = 0.78, p < 0.001 and atrial fibrillation with r = 0.79, p < 0.001. MLSI less than 0.69 cm predicted severe MS with 85 % sensitivity and 82.4 % specificity.Conclusions. Mitral leaflet separation index (MLSI) has a good correlation with 3-D MVA planimetry. MLSI less than 0.69 cm can estimate severe SM.
Analisis Kelengkapan Catatan Rekam Medis Kasus Tetralogy of Fallot pada Implementasi INA-CBGS di RSPJN Harapan Kita Sakidjan, Indriwanto
Jurnal ARSI (Administrasi Rumah Sakit Indonesia) Vol. 1, No. 1
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

This qualitative study discusses the inaccuracies on medical record entry charging, and inaccuracy on coding that caused provider bear the financial risk in the case of Tetralogy of Fallot in INA-CBG at the Pediatric Cardiology and congenital heart disease unit RS Harapan Kita from January-September 2013. This study showed that 21.4% of cases with incomplete secondary diagnosis and the difference between the claim of Rp 251.273.615,- (4%). Factors contributed incomplete secondary diagnoses are: responsiblity, physical facilities, standard operating procedure of medical record, training, monitoring, and socialization. Therefore, tt is recommended to improve: physical facilities, structure and infra-structure, standard operating procedure of medical record, socialization, training and monitoring at regular intervals
Pengaruh Tricuspid Annular Plane Systolic Excursion (TAPSE) Pasca Pembedahan Katup Mitral Terhadap Mortalitas Jangka Panjang Erriyanti, Sabrina; Soesanto, Amiliana M; Sakidjan, Indriwanto; Atmosudigdo, A.; Lilyasari, Oktavia; Ariani, Rina; Siagian, Sisca Natalia
Jurnal Kardiologi Indonesia Vol 43 No 1 (2022): Indonesian Journal of Cardiology: January - March 2022
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1196

Abstract

Abstract Background: Heart valve disease is still a significant health burden in the world, including Indonesia. The postoperative outcome of mitral valve surgery is influenced by many things, including decreased right ventricular (RV) function, which is the most common complication. Several studies have shown that decreased RV function after mitral valve surgery is associated with long-term outcomes. TAPSE is a routine and easy measurement of RV systolic function. A decrease in TAPSE after cardiac surgery is common because of the effects of pericardiotomy, and does not necessarily reflect a decrease in RV ejection fraction (RVEF). Regardless of whether postoperative TAPSE values ​​indicate right ventricular systolic function or only due to the effects of pericardiotomy, it is still not clear whether postoperative TAPSE values ​​have a prognostic value to long-term mortality after mitral valve surgery. Therefore, the objective of this study is to obtain information regarding the relationship of TAPSE echocardiographic parameters after mitral valve surgery with long-term mortality. Methods: This is a retrospective cohort study, looking at the effect of TAPSE on outcome after mitral valve surgery. The analysis starts from the starting point of the study when the patient was discharged alive from the hospital after mitral valve surgery (operation period January 2016 – February 2017) to the end point of the study, which was June 30th, 2021 and the observed outcome was mortality from any cause. Results: Of the 266 study subjects, 11 subjects died within 4-5 years after mitral valve surgery, the mortality is 4%. Bivariate analysis was performed on several factors and no relationship was found between the analyzed variables and mortality. Conclusion: There is no relationship between mortality and TAPSE after mitral valve surgery. Keywords: TAPSE, Mitral Valve Surgery, Mortality
Co-Authors Adi Purnawarman Amiliana M Soesanto Amiliana M Soesanto Anna Ulfah Rahajoe Anna Ulfah Rahajoe Ariani, Rina Atmosudigdo, A. Bambang Budi Siswanto Budhi Setianto Erriyanti, Sabrina Ganesja M Harimurti Ganesja M Harimurti Ganesja M Harimurti I Made Junior Rina Artha Nur Haryono Oktavia Lilyasari Oktavia Lilyasari Poppy S Roebiono Poppy S Roebiono Pramono Sigit Radityo Prakoso Retna Dewayani Rina Ariani Siagian, Sisca Natalia Yoga Yuniadi