Latar Belakang : Terdapat dua modalitas terapi paliatif pada populasi pasien penyakit jantung bawaan biru pulmonary duct dependent yaitu intervensi kateterisasi dengan PDA stent dan pembedahan dengan mBTT shunt. Sampai saat ini belum ada penelitian yang membandingkan luaran kedua tindakan paliatif ini pada usia yang lebih tua.Tujuan: Mengetahui luaran tindakan PDA stent dibandingkan dengan mBTT shunt sebagai terapi paliatif pada pasien penyakit jantung bawaan sianotik dengan pulmonary duct dependent.Metode : Dilakukan studi kohort retrospektif menggunakan data sekunder terhadap 143 pasien yang menjalani terapi paliatif PDA stent dan mBTT shunt pada periode Agustus 2016 sampai Agustus 2022 di RS Pusat Jantung Harapan Kita. Dilakukan pemantauan selama perawatan hingga 30 hari pasca tindakan. Hasil: Total 143 pasien yang dimasukkan ke dalam analisis luaran primer dan sekunder; 43 pasien menjalani PDA stent dan 100 pasien menjalani mBTT shunt dengan median usia kelompok PDA stent 110 (31-1498) hari dan kelompok mBTTshunt 174.5 (30-1651) hari. Komposit luaran primer tidak bermakna pada kedua kelompok meliputi mortalitas 30 hari (6(14%) vs 14 (14%), p=1,000), reintervensi (1(2,3%) vs 7 (7%),p = 0,436) , dan rehospitalisasi 30 hari (0(0%) vs 2(2%),p=0,319). Analisis luaran sekunder didapatkan angka lama rawat inap ICU lebih pendek pada kelompok PDA stent(2 (0-16) hari vs 4 (1-63) hari, p =0,002).Kesimpulan: PDA stent memiliki luaran yang tidak berbeda dengan tindakan mBTT shunt pada komposit luaran meliputi mortalitas 30 hari, reintervensi, dan rehospitalisasi 30 hari namun berbeda bermakna pada lama rawat ICU.
Background: There are two modalities of palliative therapy in the population of patient with pulmonary duct dependent which is catheterization intervention with PDA stent and surgery with BTT shunt. To date, there have been no studies that have compared the outcomes of these two palliative strategy in older age.Objectives: To determine the outcome of PDA stent compared to mBTT shunt as palliative therapy in patients with pulmonary duct dependent congenital heart disease.Methods: A retrospective cohort study was conducted using secondary data on 143 patients undergoing palliative therapy for PDA stents and mBTT shunts from August 2016 to August 2022 at National Cardiovascular Center Harapan Kita. Monitoring was carried out during treatment up to 30 days after the procedure. Results : A total of 143 patients were included in the primary and secondary outcome analysis; 43 patients underwent PDA stent and 100 patients underwent mBTT shunt with median age of PDA stent group 110 (31-1498) days and mBTT shunt group 174.5 (30-1651) days. Primary outcome composite was not significant in both groups including 30 days mortality (6(14%) vs 14(14%), p=1.000), reintervention (1(2.3%) vs 7(7%),p=0.436) , and 30 days rehospitalization (0(0%) vs 2(2%),p=0.319). Secondary outcome analysis showed shorter ICU length of stay in the PDA stent group (2 (0-16) days vs 4 (1-63) days, p = 0.002).Conclusion: PDA stent has an outcome that is not different from the mBTT shunt procedure in the composite outcome including 30 days mortality, reintervention, and 30 days rehospitalization but significantly different in ICU length of stay. |
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