Luaran Penutupan Duktus Arteriosus Persisten Transkateter di Rumah Sakit Dr. Hasan Sadikin Bandung

Abstract

Saat ini penutupan duktus arteriosus persisten (DAP) transkateter merupakan terapi pilihan karena memiliki efikasi yang baik, masa rawat yang singkat, risiko yang lebih rendah, dan bebas dari parut dada. Tujuan penelitian ini adalah mengevaluasi luaran jangka pendek dan menengah penutupan DAP transkateter. Penelitian merupakan laporan deskriptif analitik pasien yang menjalani penutupan DAP transkateter secara konsekutif di RS Dr. Hasan Sadikin Bandung selama periode Mei 2011 sampai dengan Juni 2014 dengan melakukan evaluasi pemeriksaan klinis dan ekokardiografi saat 24 jam, 1, 3, 6, dan 12 bulan setelah prosedur. Selama periode penelitian terdapat 132 pasien DAP yang menjalani penutupan transkateter, terdiri atas 42 laki-laki dan 90 perempuan, dengan median usia 3,9 tahun, berat badan 11,25 kg, tekanan sistol arteri pulmonalis 56 mmHg, ukuran defek 3,4 mm, flow ratio 2,8, fluoroscopy time 16 menit, dan procedure time 67 menit. Segera setelah prosedur 54% memperlihatkan penutupan lengkap, smoky residual 41%, dan residual ringan 6%. Sebagian besar pasien dipulangkan sehari setelah prosedur, tidak ada yang meninggal dan komplikasi hanya 3,8%. Semua pasien memperlihatkan penutupan lengkap pada follow-up. Penutupan DAP transkateter merupakan terapi yang aman dan efektif dengan masa rawat yang singkat dan komplikasi yang minimal. Evaluation was conducted through clinical examination and echocardiography 24 hours, 1, 3, 6 and 12 months after the procedure. The procedure was successful in 132 PDA patients (42 males and 90 females). The median age, body weight, systolic pulmonary artery pressure, PDA size, flow ratio, fluoroscopy time, and procedure time were 3.9 years, 11.25 kg, 56 mmHg, 3.4 mm, 2.8, 16 minutes, and 67 minutes, respectively. Immediately after the procedure, 54% patients had complete closure, 41% experienced smoky residual shunt and only 5% experienced small residual shunt. The mortality and complication rate was 3.8%. Most of the patients were discharged the next day after the procedure. All patients showed complete closure during followed-up. Transcatheter closure of PDA is safe and effective with shorter hospitalization and minimum complications. [MKB. 2016;48(4):234-40]

Time period after transcatheter PDA closure with changes in left ventricular function and nutritional status

“…9 A study in Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia showed that transcatheter PDA closure was safe and effective in short and moderate follow up, thus it is the standard of treatment, especially in medical centers with limited ward capacity. 10 A study conducted in Ain Shams University Hospital, Egypt, showed that after PDA transcatheter closure, systolic and diastolic function were significantly decreased, but still reversible and returned to normal 1 month after closure. 11 Other studies that assessed systolic function after transcatheter closure had similar results.…”