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Abstrak :
Latar belakang: Bayi prematur berisiko mengalami gangguan pertumbuhan dan keterlambatan perkembangan. Stimulasi taktil kinestetik STK dini diperlukan untuk meningkatkan luaran tumbuh kembang pada bayi prematur. Tujuan: Menilai pengaruh STK pada bayi prematur. Metode: Studi intervensi bulan Agustus 2015-Juli 2017 di Unit Neonatologi RSCM. Subjek penelitian adalah bayi prematur, direkrut dengan randomisasi dibagi menjadi dua kelompok a perlakuan b kontrol. STK dilakukan tiga kali 15 menit setiap hari selama 10 hari. Pengukuran antropometri, neurobehaviour skor Dubowitz , perkembangan kognitif dan bahasa dinilai pada kedua kelompok. Hasil: Total 126 bayi 63 kelompok perlakuan, 63 kelompok kontrol didapatkan kenaikan BB, PB lebih baik pada kelompok perlakuan dibandingkan kontrol p0,05 . Perkembangan kognitif, bahasa di antara kedua kelompok tidak berbeda signifikan DQ-CLAMS, DQ-CAT, FSDQ, p>0,05 . Simpulan: STK merupakan salah satu intervensi efektif untuk pertumbuhan bayi late preterm. ......Background Preterm neonates are at risk of impaired growth and development. These neonates need tactile kinesthetic stimulation TKS at early age that hypothesized to have good outcome of growth development in their life. Objective To evaluate the effects of TKS in preterm neonates. Method An interventional study conducted during August 2015 July 2017 in Neonatal Unit Cipto Mangunkusumo Hospital. Preterm neonates recruited by random sampling, divided into two groups a intervention b control. TKS was provided three times 15 minute periods per day for 10 days to intervention group. Changes in anthropometri, neurobehaviour Dubowitz Score , cognitive and language skill were assessed in both groups. Results There were 126 preterm neonates 63 in intervention group, 63 in control group . Over the 10 day TKS period, the intervention group gained significantly more weight, height increment compared to the control group p0.05 . There was no significant difference in cognitive, language in both groups DQ CLAMS, DQ CAT, FSDQ, p 0.05 . Conclusion TKS can be an effective way to enhance growth in late preterm neonates.

Abstrak :
Anak-anak merupakan kelompok yang berisiko mengalami gangguan pemenuhan kebutuhan oksigenasi. Tujuan studi kasus ini adalah untuk memberikan gambaran pemenuhan kebutuhan oksigenasi pada anak melalui penerapan intervensi modifikasi pursed lips breathing menggunakan pendekatan teori kenyamanan Kolcaba. Pengkajian dilakukan berdasarkan taxonomy of comfort terhadap lima kasus terpilih yang menunjukkan gangguan pemenuhan kebutuhan oksigenasi. Intervensi dan implementasi ditujukan untuk meningkatkan kenyamanan serta membuat klien berada pada level transcendence terhadap kondisi ketidaknyamanan yang dirasakan. Intervensi modifikasi pursed lips breathing sebagai intervensi comfort food for the soul terbukti efektif meningkatkan status oksigenasi anak dan dapat diaplikasikan pada anak yang mengalami gangguan pemenuhan kebutuhan oksigenasi.

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Children are groups at risk of impaired fulfillment of oxygenation requirement. This case study was aimed to describe the oxygenation fulfillment requirements in children using the pursed lips breathing modification interventions through the Kolcaba's comfort theory approach. The assessment was conducted based on the taxonomy of comfort on five selected cases indicating impaired fulfillment of oxygenation requirement. Interventions and implementations are aimed at increasing comfort and making clients transcendence against the perceived discomfort. The intervention of pursed lips breathing modification as comfort food for the soul intervention has proven to be effective in improving the oxygenation status of children and can be applied to children with impaired fulfillment of oxygenation requirement.

Abstrak :
Non-invasive respiratory support adalah suatu metode pemberian bantuan napas mekanik tanpa intubasi. High flow nasal cannula (HFNC) dan continuous positive airway pressure (CPAP) termasuk dalam golongan ini. Penelitian ini bertujuan untuk mengetahui efektivitas HFNC dibandingkan dengan CPAP pada anak dengan gagal napas hipoksemia akut. Uji klinis acak terkontrol dilakukan pada anak gagal napas hipoksemia akut (saturasi oksigen <90%) di Rumah Sakit Cipto Mangunkusumo (RSCM). Subjek dilakukan randomisasi dan terbagi ke dalam kelompok HFNC atau intubasi dengan modus CPAP. Pemeriksaan gas darah dan pengambilan parameter klinis (saturasi oksigen, laju napas, laju nadi), skor nyaman dan lingkar perut sebagai data dasar dan dalam 1 jam pasca-pemasangan alat. Sebanyak 22 subyek penelitian, kelompok HFNC dan CPAP, menunjukkan perbaikan parameter klinis dan skor nyaman yang bermakna 1 jam pasca pemasangan alat (p<0,05). Terdapat peningkatan rasio PF (PO₂/FiO₂) pada kedua kelompok dengan hasil yang bermakna pada kelompok HFNC (p = 0,023). Tidak ada perbedaan efektivitas antara HFNC dan CPAP. Penelitian ini tidak menemukan adanya efek samping aerofagi, iritasi mukosa hidung dan intoleransi minum pasca-pemasangan HFNC. Dengan demikian HFNC sama efektif dengan CPAP dalam memperbaiki parameter klinis dan rasio PF (PO₂/FiO₂) pada anak dengan gagal napas hipoksemia akut. HFNC dan CPAP dapat memberikan kenyamanan dalam pemakaiannya. ......Non-invasive respiratory support provides mechanical positive presure breathing assistance without intubation. High flow nasal cannula (HFNC) and continuous positive airway pressure (CPAP) belong to this group. This research is conducted to see the efficacy of HFNC in acute hypoxemic respiratory failure pediatric patient compared to CPAP mode through intubation. A randomized controlled trial study of children with acute hypoxemic respiratory failure (oxygen saturation less than 90%) was conducted in Cipto Mangunkusumo Hospital. Patients who met the inclusion criteria were randomized and divided into HFNC or intubated with CPAP mode group. Clinical parameters (oxygen saturation, respiratory rate, and pulse rate), comfort behaviour score, abdominal circumference, and blood gas analysis were evaluated as initial data dan within one hour after device installation. Out of 22 subjects, HFNC and CPAP group showed significant improvement in clinical parameters and comfort score within one hour after device installation (p<0,05). There was an increase of PF ratio (PO₂/FiO₂₎ in both groups with significant result for HFNC group (p=0,023). No difference in efficacy between HFNC and CPAP group. There were no adverse events of aerophagia, nasal mucosal irritation and feeding intolerance in HFNC group.

Abstrak :
ABSTRAK
Latar Belakang. Penyakit jantung bawaan (PJB) asianotik pirau kiri ke kanan merupakan kelompok PJB yang sering ditemukan. Aliran pirau yang terjadi memengaruhi sistem respiratori, sehingga terjadi ventilasi perfusi mismatch dan menurunkan compliance paru yang memudahkan pasien untuk mengalami infeksi respiratori akut (IRA) berulang. Tujuan. Mengetahui kekerapan IRA pada anak dengan PJB asianotik pirau kiri ke kanan. Metode. Penelitian ini merupakan kohort prospektif yang dilakukan di Departemen Ilmu Kesehatan Anak (IKA) dan Pelayanan Jantung Terpadu (PJT) Rumah Sakit Cipto Mangunkusumo (RSCM), selama bulan September 2012 hingga April 2013. Kelompok PJB adalah pasien PJB asianotik pirau kiri ke kanan berusia 3 bulan-5 tahun. Kelompok kontrol adalah anak yang tidak menderita PJB asianotik pirau kiri ke kanan yang diambil secara matching umur dan jenis kelamin. Data penelitian dianalisis dengan uji Kai kuadrat, t tidak berpasangan, dan Mann-Whitney menggunakan SPSS versi 19. Hasil. Penelitian dilakukan pada 100 subjek, 6 subjek mengalami drop out. Insidens IRA pada kelompok PJB asianotik pirau kiri ke kanan adalah 40-60%, kelompok kontrol 20-30% (P=0,027). Risiko relatif pasien PJB mengalami IRA adalah 2,3 kali (IK 95% 1,2-4,3) dibanding kelompok kontrol (P=0,006). Jenis IRA terbanyak pada kelompok PJB dan kontrol adalah IRA atas (118 dan 66 kasus), IRA bawah pada kelompok PJB berjumlah 26 kasus, sementara kelompok kontrol 3 kasus. Rerata episode IRA pada kelompok PJB adalah 3 (SD 1,1), kelompok kontrol 1,5 (SD 0,9) dengan P<0,0001. Kejadian IRA berulang pada kelompok PJB lebih sering dibanding kelompok kontrol (P<0,0001). Median lama IRA pada kelompok PJB adalah 7 hari (4-14 hari), sementara kelompok kontrol 5 hari (2-12 hari) P<0,0001. Simpulan. Kejadian IRA berulang pada kelompok PJB asianotik pirau kiri ke kanan lebih sering dibandingkan kelompok kontrol.

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ABSTRACT
Background. Acyanotic left-to-right shunt congenital heart disease (CHD) is the most frequent CHD. The flow of the shunt may affect the respiratory tract, resulting in ventilation perfusion mismatch and decrease the lung compliance. This, in return, will cause patient suffer from recurrent acute respiratory tract infection (ARI). Objective. To describe the frequency of ARI in children with acyanotic left-toright shunt CHD Method. This was a prospective cohort study, done in Department of Child Health and Integrated Heart Service of Cipto Mangunkusumo Hospital from September 2012 to April 2013. Subjects were acyanotic left-to-right shunt CHD with consist of children age 3 month?5 years old. Control group was children with no CHD that was matched with age and sex. Data was analyzed using chi square, unpaired t test, and Mann-Whitney test. Result. Study was performed in 100 subjects, 6 subjects were dropped out. The incidence of ARI on the CHD group was 40-60%, whereas in the control group only 20-30% (P=0.027). The relative risk of CHD patients to have ARI is 2.3 (95% CI 1.2-4.3) compared to control group (P=0.006). The most frequent ARI in CHD and control groups were upper ARI (118 and 66 cases), followed by lower ARI (26 and 3 cases). The mean frequency of ARI episode in the CHD group was 3 (SD 1.1), whereas in the control group 1.5 (SD 0.9) (P<0.0001). The recurrent of ARI cases were also more frequently found in the CHD group compared to control group (P<0.0001). The median of ARI duration in the CHD group was 7 days (4-14 days), while in the control group was 5 days (2-12 days) (P<0.0001). Conclusion. Recurrent of ARI is more frequent in the acyanotic left-to-right shunt CHD children compared to the control group.

Abstrak :
ABSTRACT
Latar belakang. Prevalens alergi makanan meningkat dalam dekade terakhir, namun belum ada data prevalens alergi makanan di Indonesia. Alergi makanan paling banyak ditemukan pada anak berusia kurang dari 3 tahun. Perolehan data prevalens dapat dilakukan dengan survei berbasis web yang memiliki hasil sebaik survei langsung.

Tujuan. Mengetahui prevalens alergi makanan pada anak usia kurang dari 3 tahun di Jakarta berbasis survei dalam jaringan (daring). Mengetahui angka penegakan diagnosis alergi makanan dari terduga alergi makanan, manifestasi klinis keluhan orangtua yang menandakan anaknya alergi makanan, jenis makanan penyebab, dan sebaran alergi makanan berdasarkan gambaran pemberian makan dan kejadian alergi keluarga.

Metode. Studi ini adalah deskriptif potong lintang menggunakan survei daring selama Januari 2011-Oktober 2013. Orangtua anak usia <3 tahun di Jakarta yang mampu mengakses internet dengan keluhan kecurigaan alergi makanan pada anaknya, melakukan log masuk di www.alergianakku.com. Kuesioner daring yang terisi kemudian diseleksi sesuai inklusi. Konfirmasi diagnosis didapatkan dengan menanyakan ulang informasi alergi, termasuk melalui pemanggilan dan pemeriksaan langsung.

Hasil. Sebanyak 286 subjek yang memenuhi kriteria inklusi; terdapat 100 subjek (35%) dengan terduga alergi makanan dan 30 subjek dari 100 subjek ditetapkan memiliki alergi makanan. Karakteristik subjek adalah mayoritas lelaki (60%) dan kelompok usia >12-36 bulan (48%). Pada kelompok alergi makanan, usia terbanyak >6-12 bulan (11/30). Gejala alergi makanan tersering adalah reaksi kulit (26/30). Makanan penyebab alergi tersering adalah susu sapi. Mayoritas subjek dengan alergi makanan mendapatkan ASI hingga usia 12 bulan (13/30); ASI eksklusif diberikan <6 bulan (23/30), dan makanan pendamping diberikan saat usia 2-4 bulan (13/30). Riwayat alergi pada keluarga (27/30) tersering adalah asma (12/30) dengan hubungan keluarga tersering ibu kandung (15/30).

Simpulan. Prevalens alergi makanan pada anak usia kurang dari 3 tahun di Jakarta berbasis survei daring adalah 10,5%. Diagnosis alergi makanan dari terduga alergi makanan adalah 30%. Keluhan tersering yang menandakan alergi makanan adalah reaksi kulit. Jenis makanan tersering penyebab alergi adalah susu sapi. Mayoritas subjek dengan alergi makanan mendapatkan ASI hingga usia 12 bulan, ASI eksklusif diberikan kurang dari 6 bulan, diberikan makanan pendamping dini, dan sebagian besar memiliki riwayat alergi keluarga dengan hubungan tersering ibu kandung dan penyakit alergi keluarga tersering adalah asma.

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ABSTRACT
Background. Prevalence of food allergy is increasing in last decade; however there is no data from Indonesia yet. Food allergy is mostly found in children below 3 years of age. Web-based surveys can be used for obtaining prevalence data as well as direct surveys.

Objectives. To know the prevalence of food allergy in children less than 3 years old in Jakarta based on online survey. To know the confirmed food allergy diagnosis from suspected food allergy, clinical manifestation of childhood food allergy based on the parent’s complaint, food etiology, and food allergy distribution based on feeding model and family allergic history.

Methods. A cross-sectional descriptive study with online survey during January 2011-October 2013. Parents, who have children <3 years old in Jakarta with suspected food allergy complaint and have access to internet, log in to www.alergianakku.com. The filled online questionnaire was selected by inclusion criteria. Confirmation of diagnosis was made by convincing allergic history, asking the subject to come and by direct examination.

Results. Total 286 subjects fulfilled the inclusion criteria; 100 subjects (35%) were suspected food allergy, and 30 out of 100 were diagnosed food allergy. The majority characteristics of subjects were male (60%) and >12-36 months age group (48%). The majority of food allergy subjects were >6-12 months age group (11/30). The most frequent food allergy symptom was skin reaction (26/30). The most frequent food etiology was cow’s milk. The food allergy subjects were breastfed until the age of 12 months (13/30); were given exclusive breastfeeding less than 6 months (23/30) and complementary food at age 2-4 months (13/30). Most of them had family allergic history (27/30), with asthma (12/30) as the most frequent disease, and the most frequent relationship was mother (15/30).

Conclusions. Prevalence of food allergy in children less than 3 years old in Jakarta based on online survey is 10.5%. The confirmed food allergy diagnosis from suspected food allergy is 30%. The most frequent clinical manifestation of childhood food allergy is skin reaction. The most frequent food etiology is cow’s milk. The food allergy subjects were breastfed until the age of 12 months; were given exclusive breastfeeding less than 6 months and complementary food at age 2-4 months. Most of them have family allergic history, the disease is asthma, and the relationship is mother

Abstrak :
Latar belakang. Cakupan imunisasi campak di Indonesia mencapai 80% namun prevalens campak di Indonesia masih tinggi, terutama pada anak usia 1-4 tahun. WHO merekomendasikan pemberian imunisasi campak ke-2 pada tahun kedua kehidupan. Di Indonesia diberikan pada usia 15-18 bulan dalam kombinasi vaksin MMR. Sayangnya cakupan imunisasi MMR masih rendah sehingga Depkes merekomendasikan pemberian imunisasi campak ke-2 pada usia 2 tahun untuk meningkatkan imunitas seorang anak terhadap penyakit campak. Tujuan. Penelitian ini untuk mengetahui: (1) proporsi anak usia 1-4 tahun yang telah mendapatkan imunisasi campak 1 kali yang memiliki antibodi campak mencapai kadar protektif dan rerata kadar antibodinya, (2) proporsi anak usia 1-4 tahun yang telah mendapatkan imunisasi campak ≥ 2 kali yang memiliki antibodi campak mencapai kadar protektif dan rerata kadar antibodinya, (3) hubungan antara usia saat diperiksa kadar antibodi campak, usia saat imunisasi, status gizi, kondisi kesehatan saat imunisasi campak terhadap antibodi campak, (4) hubungan antara pemberian imunisasi campak dosis ke-dua terhadap antibodi campak. Metode. Penelitian potong lintang di 6 posyandu di 5 wilayah DKI Jakarta pada bulan Juni hingga Agustus 2014. Anak yang memenuhi kriteria inklusi diperiksa kadar IgG campak. Dari hasil pemeriksaan IgG campak, kemudian ditentukan apakah mencapai kadar protektif atau tidak dan rerata kadar antibodinya. Dicari apakah terdapat hubungan antara imunisasi campak dosis ke-dua dengan kadar antibodi campak. Hasil. Dari 145 subjek penelitian, 125 subjek (86,2%) memiliki kadar antibodi campak yang mencapai kadar protektif (≥ 120 mIU/ml) dan 20 subjek (13,8%) memiliki kadar antibodi campak yang tidak mencapai kadar protektif (< 120 mIU/ml). Median kadar antibodi campak pada kelompok protektif adalah 844 mIU/ml, dengan nilai minimum 129 mIU/ml dan nilai maksimum 5000 mIU/ml. Kelompok usia 3-4 tahun memiliki kadar antibodi campak yang mencapai kadar protektif terbanyak (91,8%) dibanding kelompok usia 2-3 tahun (88,2%) dan 1-2 tahun (72,7%). Tidak didapatkan hubungan antara usia saat mendapatkan imunisasi campak dan status gizi terhadap kadar antibodi campak. Simpulan. (1) Proporsi anak usia 1-4 tahun yang mendapatkan imunisasi campak 1 kali dan memiliki antibodi campak mencapai kadar protektif sebesar 77% (54/70) dengan median kadar antibodinya adalah 733,5 mIU/ml, (2) Proporsi anak usia 1-4 tahun yang mendapatkan imunisasi campak ≥ 2 kali dan memiliki antibodi campak mencapai kadar protektif sebesar 94,6% (71/75) dengan median kadar antibodinya adalah 885 mIU/ml. (3) Pemberian imunisasi campak ≥ 2 kali meningkatkan timbulnya antibodi campak yang mencapai kadar protektif sebesar 1,227 kali dibanding pemberian imunisasi campak 1 kali. ...... Background. Indonesia measles immunization coverage reach 80% but measles prevalence remains high especially in children 1-4 years old. WHO recommended second dose of measles containing vaccine at second year of age. In Indonesia, it has been done through MMR vaccine at 15-18 month. Unfortunately MMR immunization coverage still low and Ministry of Health recommended second dose of measles containing vaccine for all 2 years old children who have never been immunized with MMR vaccine at 15-18 month to increase the immunity against measles. Objectives. This study aimed to know: (1) proportion of children 1-4 years old who has been immunized one time measles vaccine and reach protective antibody level and mean of antibody, (2) proportion of children 1-4 years old who has been immunized twice or more measles vaccine and reach protective antibody level and mean of antibody, (3) association between age, age of immunization, nutritional status, and health status when being immunized with measles antibody level, (4) association between second dose of measles vaccine with measles antibody level. Methods. Cross-sectional study performed in 6 posyandu in 5 region of Jakarta since June until August 2014. Children who met the inclusion criteria were checked for measles IgG, identified for reaching protective level and mean of antibody. Association between second dose of measles vaccine with measles antibody level was also measured. Results. From 145 participants, 125 (86,2%) had protective measles antibody level (≥ 120 mIU/ml) and 20 (13,8%) had not reached protective level (< 120 mIU/ml). The median measles antibody level in protective group was 844 mIU/ml, with minimum point was 129 mIU/ml and maximum point was 5000 mIU/ml. Children in 3-4 years old group had highest percentage of protective measles antibody level (91,8%) compare to children in 2-3 years old group (88,2%) and 1-2 years old group (72,7%). There were no association between age of immunization and nutritional status with measles antibody level. Conclusion. (1) Proportion of children 1-4 years old who has been immunized one time measles immunization and reach protective measles antibody level was 77% (54/70) with the median of measles antibody level was 733,5 mIU/ml, (2) Proportion of children 1-4 years old who has been immunized twice or more measles immunization and reach protective measles antibody level was 94,6% (71/75) with the median of measles antibody level was 885 mIU/ml, (3) Twice or more measles immunization will increase protective level of measles antibody 1,227 times compare to one time measles immunization.

Abstrak :
Latar Belakang. Terapi pembedahan telah menjadi baku emas dalam penutupan defek septum atrium (DSA) sekundum. Prosedur pembedahan mempunyai morbiditas yang terkait dengan torakotomi, pintasan jantung paru, komplikasi prosedur, jaringan parut bekas operasi, dan trauma psikologis. Oleh karena itu, timbul usaha pendekatan transkateter untuk menutup DSA yang bersifat relatif kurang invasif, salah satunya dengan alat Amplatzer septal occluder (ASO). Tujuan. Mengetahui perbandingan hasil penutupan DSA sekundum, komplikasi prosedur, lama rawat di rumah sakit, dan total biaya prosedur antara prosedur transkateter menggunakan ASO dengan prosedur pembedahan. Metode. Penelitian bersifat retrospektif analitik dengan sumber data berupa rekam medis pasien anak dengan DSA sekundum yang datang berobat ke Pelayanan Jantung Terpadu Rumah Sakit dr. Cipto Mangunkusumo dan dilakukan penutupan defek dengan salah satu prosedur dalam periode Januari 2005-Desember 2011. Hasil. Sebanyak 112 kasus anak dengan DSA sekundum masuk dalam penelitian, terdiri dari 70 kasus dengan prosedur pembedahan dan 42 kasus dengan prosedur transkateter. Prosedur pembedahan dan prosedur transkateter mempunyai tingkat keberhasilan yang serupa (98,6% vs 95,2%, p=0,555). Namun prosedur pembedahan mempunyai komplikasi yang lebih banyak dibandingkan prosedur transkateter (60% vs 28,6%, p=0,001, OR 1,61;95%IK,1,19-2,18). Prosedur pembedahan juga mempunyai lama rawat di rumah sakit yang lebih panjang dibandingkan prosedur transkateter (6 hari vs 2 hari, p<0,0001), dan semua prosedur pembedahan membutuhkan perawatan di ruang rawat intensif. Secara keseluruhan prosedur transkateter mempunyai total biaya prosedur yang lebih tinggi dibandingkan prosedur pembedahan (Rp.52.731.680,06 vs Rp.46.994.745,26, p<0,0001), dan biaya pengadaan alat ASO mempunyai porsi sekitar 58% dari total biaya prosedur. Analisis total biaya prosedur tanpa memperhitungkan biaya alat ASO menunjukkan prosedur transkateter mempunyai total biaya yang lebih rendah dibandingkan prosedur pembedahan. Simpulan. Prosedur transkateter dengan ASO mempunyai efektivitas yang sama dengan prosedur pembedahan dalam penutupan DSA sekundum dan mempunyai komplikasi yang lebih sedikit serta lama rawat di rumah sakit yang lebih pendek. Total biaya prosedur transkateter dengan ASO masih lebih tinggi dibandingkan prosedur pembedahan. ...... Background. Surgery has become standard therapy for secundum atrial septal defect (ASD) closure, but it has significant morbidity related to sternotomy, cardiopulmonary bypass, complication, residual scar, and trauma. Non-surgical and less invasive approaches with transcatheter device were developed to occlude ASD. Amplatzer septal occluder (ASO) is one of the commonly used devices in transcatheter closure. Objectives. This study sought to compare efficacy, complication, length of hospital stay, and total cost of secundum ASD closure procedure between transcatheter closure using ASO with surgery. Methods. A retrospective analysis was performed on children with secundum ASD admitted to Cardiology Center of Cipto Mangunkusumo Hospital from January 2005-December 2011. The patients received transcatheter closure with ASO or surgical closure. Data were obtained from medical record. Results. A total of 112 secundum ASD cases were included in study, consisted of 42 cases underwent transcatheter closure and 70 cases underwent surgical closure. The efficacy of both procedur were not statistically different (98.6% vs 95.2%, p=0.555). However, surgery procedure had more complication than transcatheter closure (60% vs 28.6%, p=0.001, OR 1.61;95%CI 1.19 to 2.18). Hospital stay were also significantly longer for surgery procedure than transcatheter closure (6 days vs 2 days, p<0.0001), and all surgical subjects requiring intensive care. Transcatheter closure had mean total cost Rp.52,731,680.06 as compared with Rp.46,994,745.26 for surgery procedure (p<0.0001), and cost of ASO represents 58% of the total cost of transcatheter closure. Mean total cost of transcatheter closure without including cost of device is less costly than surgery procedure. Conclusion. Transcatheter closure using ASO had similar efficacy with surgical closure, complication rate was lower, and the length of hospital stay was shorter. However, transcatheter closure costs were higher compared with surgery procedure.