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All Journal Jurnal Anestesiologi Indonesia Medical Journal of Indonesia Heart Science Journal
Radityo Prakoso
Faculty of Medicine, University of Indonesia/ Harapan Kita National Cardiovascular Center
Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Potential use of isosorbide dinitrate As a new drug for tilt table test of young adult subject: A study of haemodynamic effects Yuniadi, Yoga; Maharani, Erika; Prakoso, Radityo; Saragih, Robert E.; Munawar, Muhammad
Medical Journal of Indonesia Vol 15, No 1 (2006): January-March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (152.626 KB) | DOI: 10.13181/mji.v15i1.210

Abstract

Vasovagal syncope is a common health problem in young adult population. Tilt table test (TTT) is the only method to diagnose vasovagal syncope. Since isoprenaline as a standard provocative drug of TTT is hard to be found in Indonesia, we study the haemodynamic effect of isosorbide dinitrate (ISDN) which has similar venous pooling effect with isoprenaline. Seventeen young healthy adult subjects (age of 28.6 ± 4.7 year old, and 14 males) underwent TTT using 400 μg ISDN spray sublingually as a provocative drug. The haemodynamic changes were observed during baseline and provocative phase. None of 17 subjects experienced of syncope. Although, the systolic, diastolic, and mean arterial blood pressure were significantly decreased and the heart rate significantly increased after ISDN administration, but the changes were not sufficient to cause syncopal event. In conclusion sublingual ISDN spray during TTT of young healthy adult subject changes haemodynamic measures but did not cause syncope. These results give a reasonable basic for ISDN usage as provocative drug of TTT. (Med J Indones 2006; 15:24-9)Keywords: Syncope, vasovagal, tilt table test, nitrate
Left ventricular hypertrophy are associated with increased ostial pulmonary vein diameter Yuniadi, Yoga; Prakoso, Radityo; Maharani, Erika; Nagawijaya, Budi; Munawar, Muhammad
Medical Journal of Indonesia Vol 15, No 3 (2006): July-September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (188.519 KB) | DOI: 10.13181/mji.v15i3.234

Abstract

Atrial fibrillation (AF), which is called as a global epidemic disease, frequently found in hypertensive patients with left ventricular hypertrophy (LVH). Pulmonary vein (PV), which is known to have an important role in AF initiation and maintenance, increases in its diameter during AF. We sought to investigate PVs diameter changes in LVH with sinus rhythm. Of 70 hypertensive patients with sinus rhythm, 42 subjects demonstrated LVH. The mean ostial diameter of patient with and without LVH, assessed by doing spiral multisliced CT scan in the axial plane, were as follow: right superior (RSPV) of 19.6±2.78 vs 17.8±1.93 (p = 0.003), right inferior (RIPV) of 18.4±3.12 vs 16.0±2.19 (p < 0.001), left superior (LSPV) of 18.1±2.62 vs 16.0±2.16 (p < 0.001), and left inferior (LIPV) of 15.9±1.93 vs 15.4±1.85 mm (p = 0.284), respectively. Even during sinus rhythm, LVH causes PV dilation. This result might give an explanation of frequent AF prevalence in hypertensive patients. (Med J Indones 2006; 15:173-6) Keywords: Pulmonary veins, Left ventricular hypertrophy
The Current Strategy in Managing Congenital and Structural Heart Disease: Find and Treat Them Appropriately Prakoso, Radityo
Heart Science Journal Vol 5, No 2 (2024): Challenges in the Management of Congenital Heart and Structural Heart Diseases
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.02.2

Abstract

Significant progress has been made in diagnosing and treating congenital heart defects (CHDs) over the past five decades. Notable advancements include pulse oximetry screening for critical CHDs in newborns and percutaneous, catheter-based procedures, improving outcomes even in developing nations. Recent studies demonstrate favorable outcomes with device closure of acyanotic CHDs, with non-fluoroscopy techniques adopted to minimize radiation risks. Positive results are observed with right ventricular outflow tract (RVOT) stent palliation for late-presenting cyanotic congenital heart diseases such as tetralogy of Fallot (TOF). Novel interventions like reverse Potts shunt anastomosis show promise in managing pediatric pulmonary arterial hypertension (PAH), while prophylactic treatments effectively reduce postoperative arrhythmias. Fontan procedure significantly enhances survival rates for individuals with single functional ventricles, although challenges arise with aging populations. In developed countries, fetal cardiac interventions utilizing advanced imaging techniques allow for early detection and preventive interventions, reducing secondary complications.
Successful of High Risk Pulseless-Balloon Aortic Valvuloplasty Procedure in Uncorrected Pulmonary Atresia with Severe Congenital Aortic Stenosis and Low Left Ventricular Function Sofia, Sefri Noventi; Bahrudin, Bahrudin; Riwanto, Ignatius; Susanto, Hardhono; Soetadji, Anindita; Baskoro, Adhi Gunawan; Prawara, Ananta Sidhi; Satyagraha, Muhammad Thifan; Kurniawati, Yovie; Prakoso, Radityo
JAI (Jurnal Anestesiologi Indonesia) Publication In-Press
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.72347

Abstract

Background: Pulmonary atresia with ventricular septal defect (PA-VSD) and severe bicuspid aortic stenosis (AS) is an uncommon condition that presents significant surgical challenges. The dual obstruction leads to chronic pressure overload, resulting in ventricular hypertrophy and decreased systolic function. A low left ventricular ejection fraction (LVEF) increases the risk of mortality during surgical interventions. Percutaneous balloon aortic valvuloplasty (BAV) poses additional risks due to the intentional induction of pulselessness during balloon inflation. This case report aims to detail the perioperative management strategies employed during BAV in a patient with PA-VSD, severe AS, and low LVEF.Case: We present a 19-year-old female patient weighing 45 kg, who presented with shortness of breath and fatigue. Her oxygen saturation was measured at 90% across all extremities. Electrocardiogram findings indicated sinus rhythm with biventricular hypertrophy and incomplete left bundle branch block. Chest X-ray revealed cardiomegaly and pulmonary artery dilation, while echocardiography confirmed PA-VSD, severe AS with a mean pressure gradient (mPG) of 55 mmHg, and an LVEF of 41.3%. A percutaneous pulseless-BAV was performed using a Tyshak balloon via an antegrade transvenous femoral approach under fluoroscopy and transesophageal echocardiography guidance.Discussion: Anesthesia management focused on gradual medication titration, minimizing patient movement during the procedure, and ensuring comfort due to TEE probe insertion. A temporary pacemaker was placed in the right ventricle apex for pacing at 220 beats per minute until cardiac arrest occurred post-balloon inflation; defibrillation successfully restored spontaneous circulation.Conclusion: This case illustrates that percutaneous BAV in uncorrected PA-VSD with severe AS and low LVEF is feasible despite its inherent risks when conducted by a skilled team utilizing careful judgment throughout the procedure.
Co-Authors Anindita Soetadji Bahrudin Bahrudin Baskoro, Adhi Gunawan Budi Nagawijaya Erika Maharani Hardhono Susanto Ignatius Riwanto, Ignatius Kurniawati, Yovie Muhammad Munawar Prawara, Ananta Sidhi Robert E. Saragih Satyagraha, Muhammad Thifan Sefri Noventi Sofia Yoga Yuniadi Yoga Yuniadi