Manajemen Ruptur Septum Ventrikel Pasca Infark Miokard Akut di Rumah Sakit tanpa Fasilitas Bedah
DOI:
https://doi.org/10.21776/ub.jkb.2017.029.03.16Keywords:
Infark miokard akut, operasi, ruptur septum ventrikel, transcatheter septal occluderAbstract
Ruptur septum ventrikel merupakan komplikasi mekanik yang sangat jarang terjadi pada pasien infark miokard akut (IMA) namun memiliki mortalitas yang tinggi. Sejak dimulainya era reperfusi modern, insiden ruptur septum ventrikel semakin menurun sampai dengan 0,2% kasus IMA. Dalam laporan kasus ini kami laporkan 2 pasien ruptur septum ventrikel pasca IMA. Pasien mendapatkan perawatan intensif dan terapi medikamentosa, selama dalam masa perawatan hemodinamik cenderung tidak stabil dan meninggal beberapa hari kemudian tanpa tindakan invasif karena keterbatasan fasilitas. Intra aortic counterpulsation balloon pump (IABP) dapat dipertimbangkan sebelum operasi sebagai bridging therapy. Operasi merupakan standar baku emas terapi dan bersama dengan Coronary Artery Bypass Graft (CABG) tanpa melihat status hemodinamik. Hasil yang optimal dapat dicapai pada 2-6 minggu pasca serangan akut namun demikian penutupan defek dengan transcatheter septal occluder dalam keadaan tertentu dapat dipertimbangkan.
Kata Kunci: Infark miokard akut, operasi, ruptur septum ventrikel, transcatheter septal occluder
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