Tesis

Korelasi Indeks Volume Akhir Diastolik Ventrikel Kiri Preoperasi dengan Luaran Jangka Pendek Pasca Operasi Penutupan Defek Septum Atrial Sekundum = The Correlation of Preoperative Left Ventricular End Diastolic Volume Index with Short-term Outcome of Secundum Atrial Septal Defect Surgical Closure.

Latar belakang: Berbagai parameter fungsi dan dimensi ventrikel preoperasi pada defek septum atrial sekundum (DSAS) telah banyak diteliti sebelumnya. Namun korelasi antara indeks volume akhir diastolik ventrikel kiri (IVADVKi) preoperasi dengan luaran jangka pendek pasca operasi penutupan DSAS belum pernah dieksplorasi. Tujuan: Untuk mencari korelasi antara IVADVKi preoperasi dengan luaran jangka pendek pasca operasi penutupan DSAS. Metode: Kami melakukan analisis semua pasien yang dilakukan operasi penutupan DSAS yang telah diperiksa dengan magnetic resonance imaging (MRI) kardiak preoperasi antara Januari 2013-Desember 2017. Pemeriksaan MRI dilakukan dengan Philips Medical System Scanner 1,5 T dengan 32-elements phase sense torso cardiac coil. Volume dan fungsi diukur pada pandangan short axis dalam cine steady state free precession free breathing sequence. Hasil: Dari 30 pasien yang memenuhi kriteria inklusi dan eksklusi, 86,7% adalah wanita, usia 31,97  13,53 (7-59) tahun, body surface area (BSA) 1,39  0,24 (0,9-2,0) m 2 . Nilai IVADVKi memiliki korelasi negatif signifikan (r= -0,399, p=0,029) dengan lama rawat ICU >2 hari pasca operasi, korelasi negatif nonsignifikan dengan aritmia pasca operasi, edema paru, krisis hipertensi arteri pulmonal, penggunaan vasodilator intravena atau inodilator, lama rawat rumah sakit >5 hari, lama ventilator >6 jam, dengan r secara berurutan: r= -0,183, r= 0,158, r= -0,297, r= -0,049, r= -0,050, r= -0,210. Tidak terdapat angka kematian dalam penelitian ini. Kesimpulan: IVADVKi berkorelasi negatif lemah dengan lama rawat ICU pasca operasi penutupan DSAS dan berkorelasi negatif sangat lemah dengan luaran lainnya.
Kata kunci : defek septum atrium sekundum, indeks volume akhir diastolik ventrikel kiri, magnetic resonance imaging


Background: Various preoperative function and dimension parameters of ventricle in secundum atrial septal defect (ASD) have been extensively researched. Nevertheless the correlation between preoperative left ventricular end diastolic volume index (LVEDVi) with short-term postoperative outcome after ASD closure has never been explored. Objective: To determine the correlation between preoperative LVEDVi and short-term postoperative outcome after ASD closure. Methods: We reviewed all consecutive surgical ASD closure patients who underwent cardiac magnetic resonance imaging (MRI) previously at our institution between January 2013-December 2017. The MRI examination was performed with 1.5 T Philips Medical System Scanner with 32-elements phase sense torso cardiac coil. Volume and function was measured from short axis view in cine steady state free precession free breathing sequence. Results: From 30 patients who fulfilled inclusion and exclusion criteria, 86.7% was female gender, age was 31,97  13,53 (7-59) years old, body surface area (BSA) was 1,39  0,24 (0,9-2,0) m 2 . The LVEDVi had a negative correlation (r= - 0,399, p=0,029) with LOS ICU >2 days postoperatively, a nonsignificant negative correlation with postoperative arrhythmia, pulmonary oedema, pulmonary arterial hypertension crisis, intravenous vasodilator or inodilator, LOS in hospital >5 days, ventilator duration >6 hours with r= -0,183, r= -0,158, r= -0,297, r= -0,049, r= -0,050, r= -0,210, respectively. No mortality was observed in this study. Conclusion: LVEDVi had a weak negative correlation with LOS ICU post surgical closure of secundum ASD and a very weak negative correlation with other outcomes.
Keywords: secundum atrial septum defect, left ventricular end diastolic volume index, magnetic resonance imaging