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Iskandar Iskandar
Department of Cardiology and Vascular Medicine
– Faculty of Medicine, Universitas Brawijaya

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The Nightmare in Defect Occlusion by Transcatheter: A Case Report Iskandar Iskandar; Seprian Widasmara; Ratna Pancasari; Heny Martini
Heart Science Journal Vol 3, No 3 (2022): Cardiovascular Disease in Young Adulthood: Who, When, and How to Screen?
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2022.003.03.7

Abstract

Background : ASD closure ASD closure with a transcatheter is the first choice in patients who meet the criteria for insertion. Closure using this method is relatively safe, and has low complications. Several factors must be considered so that this closure action can be optimal. Case illustrations:A 24-year-old woman with complaints of shortness of breath during strenuous activities since 3 years ago. Transthroracal echocardiography showed a gap in the IAS of 1.7-1.9 cm. The patient then underwent TEE and DXRL. The patient was planned for percutaneous ASD closure with zero fluoroscopy. The patient was punctured on the right femoral, and entered into the occluder memopart no 24 mm. Do a wriggle test, the occlude tool is installed properly. When the device was pulled out, the patient's blood pressure dropped to 75/52. On TEE examination, pericardial effusion was found and pericardiocentesis was performed, obtained 600 cc of fluid. The patient was then observed in the ICVCU, and there was no additional free fluid in the pericardial cavity. Discussions:ASD closure can be done through percutaneous and surgery. Closure via percutaneous is the main option. Complications and treatment period is shorter than surgery. Preparation and timing of appropriate action is closely related to clinical outcomes. Observation and knowledge of the risks of the procedure are very important to be able to detect complications and optimize clinical outcomes.  
The Relationship of Heart Rate Recovery Post Exercise Stress Test To Syntax Values In Patients With Stable Coronary Artery Disease Iskandar Iskandar; Setyasih Anjarwani; Cholid Tri Tjahjono; Budi Satrijo; Valerinna Yogibuana Swastika Putri
Heart Science Journal Vol 3, No 4 (2022): Prevention, Screening dan Rehabilitation : The Back Bone of Quality Care Improve
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2022.003.04.4

Abstract

Background:The prognostic usefulness of abnormal heart rate recovery (HRR) as a predictor of death has been discovered. Abnormal HRR results from inadequate vagal activation after exercise. The association between HRR and angiography in CAD (coronary artery disease) has been studied, however the conclusions are still being contested due to a lack of data. The purpose of this study is to see if HRR after an EST (exercise stress test) may predict the severity of syntax values in individuals with stable CAD at Saiful Anwar Hospital Malang (RSSA). Methods:This study is an analytic observational study with a retrospective cross sectional design. It was held in Saful anwar, Malang Hospital during January 2017–December 2019, including 366 patients. All patients underwent exercise stress test for CAD screening and coroner angiography. Those were divided into two groups, which included syntax score  < 23 (n=148) and syntax score ≥ 23 (n= 218). Result: Chi-square analysis was used to analyze the relationship correlation between HRR1, HRR2 and Syntax Score, and was used to compared between HRR1 (heart rate recovery first minutes), HRR2 (heart rate recovery second minute) and Syntax Score group. The confounding factor was adjusted with multivariate logistic regression analysis and AUC curve. There was a significant negatif correlation between abnormal HRR1 and HRR2 after exercise and Syntax score, with strong correlation (HRR1 ; OR = -2.11, p = 0.00 AUC :90,8%, HRR2 ; OR = -1,6, p = 0,48, AUC : 70,4%).  Conclusion: Abnormal first and second minutes of HRR after exercise stress test in stable CAD patient have a higher incidence of high Syntax Score (>1) than stable CAD patient with normal HRR. Keywords: Coronary artery disease (CAD), Heart rate recovery (HRR), Syntax.