DOI: https://doi.org/10.14710/jai.v13i1.24820

Pulsatile Bidirectional Cavopulmonary Shunt pada Anomali Ebstein Dewasa: Manajemen Perioperatif

SMF Anestesi dan Terapi Intensif Pasca Bedah Jantung, Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita, Jakarta, Indonesia

Received: 6 Aug 2019; Published: 31 Mar 2021.

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Abstract

Latar Belakang: Anomali Ebstein meliputi malformasi bentuk dan pergeseran katup trikuspid yang letaknya lebih ke arah apex dari ventrikel kanan. Tindakan tricuspid valve repair biasanya dipilih untuk tatalaksana definitif pada kasus ventrikel kanan yang adekuat, sedangkan bidirectional cavopulmonary shunt (BCPS) dipilih sebagai tindakan paliatif.

Kasus: Pada pasien ini kelainan terdeteksi di usia dewasa, dimana memiliki prognosis

keluaran klinis yang lebih baik dibanding kasus neonatus. Pasien menunjukkan adanya penurunan aktivitas fisik, jantung berdebar, kelainan hepatomegali, dan kelainan bunyi jantung. Pemulihan pascaoperasi terbilang cukup sulit dan lama.

Pembahasan: Ventrikel yang telah mengalami fibrosis dan dilatasi harus diantisipasi agar dapat mempertahankan hemodinamik yang baik. manajemen awal pascaoperasi difokuskan pada pengurangan afterload dan mempertahankan kontraktilitas ventrikel kanan guna mengoptimalkan stroke volume jantung kanan

Kesimpulan: Manajemen pascaoperasi pada kasus ebstein sangat bervariasi dan amat bergantung pada derajat kelainan serta usia pasien. Teknik diagnostik, pembedahan, dan manajemen pascaoperasi yang lebih baik di era sekarang membuat keluaran klinis juga menjadi lebih baik.

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Keywords: anomali; BCPS; dewasa; ebstein, perioperatif
Funding: hospital

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Section: Case Reports
Language : ID
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