Penutupan Defek Septum Ventrikel Secara Transtorakalis Minimal Invasif dengan Panduan Transesophageal Echocardiography (TEE)

Abstract

Defek septum ventrikel (ventricular septal defect/VSD) merupakan penyakit jantung bawaan yang paling sering ditemukan pada bayi dan anak. Penutupan defek ini masih memberikan tantangan tersendiri.  Penanganan VSD dengan metode minimally invasive transthoracic merupakan perkembangan inovatif penutupan defek ventrikel. Laporan kasus ini bertujuan memperkenalkan metode terbaru dalam penanganan kasus VSD yang dilakukan di RSUP Dr. Mohammad Hoesin Palembang. Kami melaporkan serial kasus penutupan VSD menggunakan metode minimally invasive transthoracic dengan panduan transesophageal echocardiography (TEE). Transesophageal echocardiography digunakan selama prosedur sebagai panduan penempatan alat dan mengevaluasi hasil operasi. Empat pasien pada periode November 2015 menjalani prosedur penutupan defek, dua pasien laki-laki dan dua perempuan, usia 2 tahun sampai 4 tahun dengan berat badan 12–22 kg, dengan  diameter VSD berdasar atas pemeriksaan ekokardiografi 4–7 mm. Penutupan VSD menggunakan metode minimally invasive transthoracic dengan panduan TEE melalui mini sternotomi menunjukkan prosedur yang aman dan efektif. Penggunaan TEE memberikan informasi yang sangat berguna selama periode intraoperatif.Kata kunci: Defek septum ventrikel, minimal invasif, transesophageal echocardiography Minimally Invasive Transthoracic Ventricular Septal Defect Closure Using Transesophageal Echocardiography GuidanceVentricular septal defect (VSD) is the most common congenital heart disease found in infants and children. Up until now, management of VSD closure remains as a challenge for clinician. Ventricular septal defect closure with minimally invasive transthoracic method is an innovative development of ventricular defect closure. This case report aims to introduce the method of minimally invasive transthoracic VSD closure, which is the latest method in handling cases of VSD conducted at Dr. Mohammad Hoesin General Hospital Palembang. We report a case series VSD closure by the method of minimally invasive transthoracic with transesophageal echocardiography (TEE) guidance. Transesophageal echocardiography is used during the procedure as guidance for the placement of the device, and to evaluate the results of operations. Four patients of the period November 2015. Two girls patients and two boys, ages 2 years to 4 years old weighing 12–22 kg, with a diameter of VSD echocardiography examination between 4–7 mm. The closure of VSD using minimally invasive transthoracic under TEE guiding through mini-sternotomy indicate a safe and effective procedure. The use of TEE provides very useful information during the intraoperative period.Key words: Minimally invasive, transesophageal echocardiography, venticular septal defect