BACKGROUND The European system for cardiac operative risk evaluation (EuroSCORE) II is one of the established risk models used to predict mortality after cardiac surgery. However, its application as a mortality predictor for Indonesian adult cardiac surgery is still unknown. This study aimed to examine the validation of EuroSCORE II in predicting the mortality following adult cardiac surgery in Indonesian adults. METHODS This retrospective cohort study collected data from the medical records and the database of the Department of Thoracic Cardiac and Vascular Surgery at Soetomo General Hospital, Surabaya. Data on the EuroSCORE II variables were collected for patients aged >18 years who underwent coronary artery bypass, heart valve, heart tumors, aortic surgeries, or a combination of these surgeries between January 2016 and December 2018. In-hospital mortality prediction was calculated using the online calculator at www.euroscore.org. The calibration of the EuroSCORE II model was conducted using the Hosmer–Lemeshow test, and discrimination analysis was done using receiver operating characteristic (ROC) curves with area under the ROC curve (AUC) calculation. RESULTS A total of 213 patients met the inclusion criteria and were analyzed for this study. Mortality was 8.9%. The predicted and actual mortalities were 1.74% and 8.9%, respectively. The significance (p-value) of the Hosmer–Lemeshow test was 0.55, indicating good calibration. The AUC of ROC curve was 0.85 (95% CI = 0.77–0.92, p<0.001), suggesting good discrimination. CONCLUSIONS EuroSCORE II has a good calibration and discrimination for cardiac surgery in Indonesian adults.

We presented a 60-year-old woman with an history of end-stage renal disease on regular hemodialysis, twice a week, came with a tunneled dialysis catheter (TDC) that was attached to the right internal jugular vein. TDC has been dysfunction since one week ago that was suspected as a result of thrombosis in the lumen of TDC. TDC was trimmed at the insertion of the jugular vein. And then a wire was inserted into TDC that has been trimmed. From Chest x-ray imaging, migration of fragmented TDC was found inside the heart chamber with wire inside the lumen. Fluoroscopy showed a picture of a fragmented TDC in the heart chamber with a wire inside the lumen. Retrieval of fragmented TDC used percutaneus snare loop method with wire guiding that was inserted through the left femoral vein. Fragmented TDC was removed successfully. Retrieval of the fragmented TDC through endovascular techniques is classified as a simple. Simple snare loop method is quite effective and very cheap compared to the commercial snare, open surgery or laparoscopic surgery that can be avoided. Kami melaporkan seorang wanita 60 tahun dengan riwayat penyakit saat ini adalah gagal ginjal kronik dengan hemodialisa reguler dua kali seminggu. TDC terpasang di vena jugularis interna kanan. TDC mengalami disfungsi sejak 1 minggu lalu, dicurigai akibat dari trombosis yang terbentuk di dalam lumen kateter hemodialisa. TDC kemudian digunting sebagian pada insersi vena jugular dan wire dimasukkan ke dalam kateter hemodialisa tersebut. Dari pencitraan X-ray didapatkan migrasi bagian kateter hemodialisa berada di dalam ruang jantung dengan wire di dalam lumen kateter hemodialisa. Fluoroskopi menunjukkan gambaran sebagian kateter hemodialisa berada di ruang jantung dengan wire terpasang di dalam potongan lumen kateter hemodialisa. Ekstraksi sebagian kateter hemodialisa dilakukan menggunakan metode loop snare dengan akses guiding wire yang dimasukkan melalui vena femoralis kiri. Fragmen kateter kemudian berhasil dikeluarkan. Pengambilan fragmen melalui endovaskular tergolong teknik yang sederhana. Loop snare yang sederhana sudah cukup efektif dan murah dibanding komersial snare, sehingga pembedahan terbuka ataupun laparaskopik dapat dihindari.