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"Approximately 120 different surgical procedures are used to correct congenital heart diseases, and the burden that this places on the surgeon is compounded by the exceptional complexity of the techniques and the rarity of many of the lesions. Training is problematic, not least because of legal issues, and currently available texts, drawings, and images are no substitute for real ‘live’ surgery.Against this background, the authors have set out to create an interactive multimedia manual that covers many aspects of congenital heart surgery. Each heart defect is addressed in an individual chapter, elaborating specific surgical anatomy and indication for surgery of heart defect first, followed by video clips depicting the operative approach and technique. The clips are accompanied by a clear descriptive narrative, and patient history and diagnostic images are available to provide a clear backdrop to the operation. "

"Paralisis diafragma pasca operasi penyakit jantung bawaan dapat meningkatkan mortalitas dan morbitas pasien. Penegakkan diagnosa kelainan ini menjadi kunci untuk pengambilan keputusan tindak lanjut seperti plikasi diafragma. Fluoroskopi sebagai baku emas memiliki keterbatasan untuk dilakukan pada pasien pasca operasi penyakit jantung bawaan. Dari 2.287 operasi penyakit jantung yang dilakukan di RSJPDHK terdapat 41 pasien yang memenuhi kriteria inklusi dan eksklusi. Median usia pasien 10 (1-119) bulan dan 43,9% berjenis kelamin laki-laki. Terdapat perbedaan bermakna pada jenis operasi yang dijalani. Dari hasil perhitungan didapatkan sensitivitas dan spesifisitas USG diafragma dibandingkan fluoroskopi pada subjek penelitian sebesar 100%(95%CI 82,35%-100%) untuk sensitivitas, dan 95.5%(95% CI 77,16%-99,88%) untuk spesifisitas. Lebih lanjut dilakukan perhitungan nilai prediksi positif dengan hasil 95%(95%CI 73,68%-99,27%) dan nilai prediksi negatif 100% (95% CI 83,89%-100%). Ultrasonografi memiliki sensitivitas dan spesifisitas yang baik dibandingkan fluoroskopi sebagai metode diagnostik pada populasi dengan kecurigaan paralisis diafragma pasca operasi penyakit jantung bawaan dengan sensitivitas 100% dan spesifisitas 95.5%.

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Diaphragmatic paralysis after congenital heart disease surgery can increase patient mortality and morbidity. Establishing a diagnosis of this disorder is key for making follow-up decisions such as diaphragm plication. Fluoroscopy as the gold standard has limitations for performing post-surgical patients with congenital heart disease.This study is a comparative diagnostic study that evaluates the ability of diaphragmatic ultrasound to diagnose diaphragmatic paralysis in patients with suspected diaphragmatic paralysis after surgery for congenital heart disease at RSJPDHK from June 2022 to May 2024. Each diaphragmatic ultrasound result was recorded and compared with the findings on fluoroscopy examination. Of the 2,287 heart surgery performed at RSJPDHK, there were 41 patients who met the inclusion and exclusion criteria. The median patient age was 10 (1-119) months and 43.9% were male. There are significant differences in the type of surgery undertaken. From the calculation results, it was found that the sensitivity and specificity of diaphragm ultrasound compared to fluoroscopy in research subjects was 100% (95% CI 82.35% - 100%) for sensitivity, and 95.5% (95% CI 77.16% - 99.88%) for specificity. Furthermore, the positive predictive value was calculated with results of 95% (95% CI 73.68%-99.27%) and negative predictive value of 100% (95% CI 83.89%-100%). Ultrasonography has good sensitivity and specificity compared to fluoroscopy as a diagnostic method in the population with suspected diaphragmatic paralysis after surgery for congenital heart disease with a sensitivity of 100% and a specificity of 95.5%."

"Sekitar 1% anak terlahir dengan penyakit jantung bawaan (PJB). Sebagian akan memerlukan kateterisasi jantung baik diagnosis maupun terapeutik. Prosedur ini memerlukan kooperasi pasien dan imobilisasi sehingga dibutuhkan anestesia yang mungkin berulang. Penelitian ini bertujuan melihat efek anestesia umum terhadap fungsi kontraktilitas jantung anak dengan PJB. Kontraktilitas jantung dilihat dari fraksi ejeksi dan TAPSE yang diukur dengan ekokardiografi. Pengukuran dilakukan sebelum anestesia umum, 5 menit pascaintubasi dan akhir tindakan kateterisasi. Metode penelitian kohort observasional dengan consecutive sampling telah dilakukan. Analisis dilakukan terhadap 42 anak berusia 6 bulan hingga 18 tahun dengan PJB yang menjalani kateterisasi jantung dalam anestesia umum pada periode Juni – Agustus 2018. Uji T-test berpasangan dilakukan untuk analisis perubahan fraksi ejeksi dan TAPSE dan analisis multivariat untuk melihat pengaruh usia, jenis PJB, lama dan jenis tindakan kardiologi terhadap perubahan kontraksi. Perubahan fraksi ejeksi turun bermakna pada 5 menit pascaintubasi dan akhir tindakan kardiologi dan TAPSE turun bermakna hanya pada 5 menit pascaintubasi. Pengaruh usia, jenis PJB, lama dan jenis tindakan kardiologi tidak bermakna terhadap perubahan fraksi ejeksi dan TAPSE. Dengan demikian diharapkan kewaspadaan dalam penanganan pasien PJB, termasuk ketika memberikan informasi sebelum persetujuan tindakan medis (informed consent), dan jika memungkinkan menghindari tindakan anestesia umum yang berulang.

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Approximately 1% of children borned with congenital heart disease (CHD). Some will require cardiac catheterization which repeated anesthesia may be needed. This study aims to see the effect of general anesthesia on the cardiac contractility in children with CHD. Cardiac contractility seen from ejection fraction and TAPSE as measured by echocardiography. Measurements were taken before general anesthesia, 5 minutes post-intubation and at the end of the catheterization. An observational cohort with consecutive sampling was conducted. Analysis was carried out on 42 children aged 6 months to 18 years with CHD who underwent cardiac catheterization under general anesthesia in the period June - August 2018. Paired T-test was performed to analyze changes in ejection fraction and TAPSE and multivariate analysis to analyze the effect of age, type of CHD, duration and type of cardiology intervention. Ejection fraction decreased significantly at 5 minutes post-intubation and at the end of cardiology intervention and TAPSE decreased significantly only at 5 minutes post-intubation. Changes of contratility was not significant affected by age, type of CHD, duration and type of cardiology intervention. Therefore, alertness in handling patients with CHD is expected, including when providing information prior to informed consent, and if possible avoid repeated general anesthesia."