Background:The alternative device to close perimembranous ventricular septal defect (pmVSD) has been searched for better result, less complications and applicable for infants. However, the ideal device is still unavailable. We aimed to evaluate the effectiveness and outcome of transcatheter pmVSD closure using the KONAR-multi functional occluder (MFO).Methods: Clinical, procedural, follow-up data of pmVSD patients with symptom of heart failure or evidence of significant left to right shunt, growth failure, recurrent respiratory tract infection, and history of endocarditis who underwent transcatheter closure using the MFO were prospectively evaluated. Results:Between January 2016 and December 2017, there were complete records of 132 pmVSD children closed using MFO from eleven centers in Indonesia. The median of age was 4.5 (0.3-17.4) years; weight 14.8 (3.5-57) kg, defect size at the smallest part 3.4 (1.0-8.1) mm, flow ratio 1.6 (1.3-4.9), mean pulmonary artery pressure 18 (7-79) mmHg, fluoroscopy time 18 (3.8-91) and procedural time 75 (26-290) minutes. A retrograde approach was done in 41 (31%) patients. Procedures succeeded in first 2 Kuswiyanto et al.
Background Few studies perform follow ups on patent ductus arteriosus (PDA) patients who undergo transcatheter closure. In addition to side effects from the procedure, it is important to evaluate changes in left ventricular function (LVF) parameters and nutritional status. Objective To compare LVF and nutritional status before and during the one-year period post-transcatheter PDA closure, and evaluate potential associated factors in post-closure PDA transcatheter patients. Methods This retrospective cohort study was done in a single center in patients diagnosed with PDA who had undergone transcatheter closure. Data were obtained from subjects’ medical records. The relationship between the post-closure PDA time span and LVF parameters [ejection fraction (EF) and fractional shortening (FS)] was analyzed by Friedman and repeated ANOVA tests; the post-closure PDA time period and nutritional status was analyzed by Friedman test. The time periods analyzed were 1, 3, 6, and 12 months post-closure. Factors potentially associated with LVF 12 months post-closure were analyzed by linear regression. Results A total of 30 patients who had undergone transcatheter PDA closure were included. The body weight mean of at the time of transcatheter PDA closure was 13.1 kg. We found a significant relationship between time period after PDA closure and nutritional status, before and 1, 3, 6, and at 12 months post-closure. In a comparison of pre-closure to 12 months post-closure, subjects’ mean EF (66.6 vs. 70.9%, respectively; P<0.001) and FS (34.4 vs. 37.8%, respectively; P<0.001) were significantly higher. In addition, significantly more patients had normal nutritional status 12 months post-closure than before closure. Age was not related to LVF parameters (EF: r=0.212; P=0.260; FS: r=0.137; P=0.471). Conclusion Both LVF and nutritional status significantly improve gradually over the 12 months post-closure compared to pre-closure. PDA size is not significantly associated with improved LVF parameters and nutritional status.
Background: Rheumatic heart disease is an acquired disease that has characterized damaged valve and it effects the quality of life in children. Aim: To asses quality of life in patient with rheumatic heart disease by using Pediatric Quality of Life Inventory (PedsQL) instrument at pediatric cardiologist. Methods: A descriptive study with cross sectional study conduct among children aged 5 to 18 years old attend the Pediatric Cardiology at Haji Adam Malik Hospital Medan, from 2016 to 2018. Result: A hundred children with rheumatic heart disease in this study who had affected quality of life-based on group age with 5 to 7 year old in physical function was 6 subjects (85.7%), social function was 1 subject (14.2%), and school function was 2 subjects (28.5%) (Table 3); group age with 8 to 12 year old in physical function was 100 subjects (100%), emotional function was 3 subjects (3%), social function was 1 subject (3%), and school function was 5 subjects (15.1%); group aged 13 to 18 year old in physical function was 60 subjects (100%), emotional function was 1 subject (16.7%), and school function was 51 subjects (85%). Conclusion: From 100 children with RHD dominant in group aged 13-18 years old and male, mal malnutrition status, using of erythromycin, high senior school of level parents’ education, and valve disorder was mitral regurgitation. The quality of life was affected in all age groups, especially in the domain of physical function, and school functions with RHD.
Background Major achievements in congenital heart disease (CHD) treatment over the past 20 years have altered the course and prognosis of CHD. Improvement of quality of life (QoL) is now a major goal of CHD treatment. Objective To assess the QoL in children after cardiac surgery for CHD. Methods A cross-sectional study was performed in children aged 2 to 18 years. The case group had 20 children with a history of corrective heart surgery in the 12 months prior to the study. The control group had 20 healthy children, age-matched to the case group. The QoL of both groups was assessed by Pediatric Quality of Life Inventory (PedsQL) Generic Core Scales. The same post-operative children were also assessed with the PedsQL Cardiac Module. Data were analyzed using T-test with P < 0.05 as the level of significance. Results This study recruited 40 subjects: 20 post-operative and 20 healthy children. PedsQL Generic Core Scales assessment showed significant differences between groups in the physical function parameter of QoL (P<0.05) in children aged 13-18 years, but there were no significant differences in the social, emotional, and school function parameters. In children aged 2-12 years, there were no significant differences in physical, social, emotional, or school parameters. The PedsQL Cardiac Module assessment revealed that 35% of post-operative children was at risk for physical appearance problems, 80% was at risk for anxiety problems, 40% was at risk for cognitive problems, and 80% was at risk for communication problems. Conclusion Thirteen to 18-year-old children with non complex CHD have poorer physical function than healthy children. Post operative children are at risk for physical appearance, anxiety, cognitive, and communication problems.
BACKGROUND: Rheumatic fever and rheumatic heart disease (RHD) are the most common acquired heart diseases in children. Environmental factors have been reported to play an important role in RHD's prevalence. AIM:The main purpose of this study is to assess the associations between environmental factors and RHD in children. METHODS:A case-control study was conducted in the Department of Child Health, Haji Adam Malik Hospital from April to June 2017. The case group consisted of children aged 5-18 years with RHD while control group consisted of healthy children. Demographic, anthropometric, and laboratory data were collected along with environmental factors. Statistical analysis was done using Statistical Product and Service Solution. A P value of <0,05 with 95% confidence interval was considered significant. RESULTS:A total of 39 children were enrolled in each group. Subjects' father who only went to elementary and junior high school had a higher risk of having children with RHD (OR 28; p = 0.032 and OR 15.75; p = 0.011, respectively). Subjects' mother who only went to junior high school had 7 times higher risk of having children with RHD (p = 0.026). Low monthly income increased the risk of RHD (OR 3,68; p = 0,009). Tap water usage, meat consumption more than once per week, and feasibility to buy clothes >1 pair per year decreased the risk of RHD at 0,31 (p = 0,013), 0,3 (p = 0,016), and 0,04 times (p <0,001), respectively. CONCLUSION: Parent's education, monthly family income, water source, frequency of meat consumption, and feasibility to buy clothes are related to RHD in children.
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