Page 128 - Abstract Book KONIKA 18

Cardiology

P-CAR-023
Nutritional Status of Children with Patent Ductus Arteriosus before Closure

Idham Muhammad, Sri Endah Rahayuningsih
Department of Child Health, Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital,
Bandung, West Java, Indonesia
Background Patent ductus arteriosus (PDA) is a failure of ductus arteriosus closure, mainly caused by
prematurity so that the ductus remains open until 7 days. The incidence of PDA was 64% in infants born
at 27-28 weeks of gestation and 87% at 24 weeks of gestation. Several studies reported that congenital
heart disease (CHD) associated with nutritional disorders and corelated significantly with low hemoglobin
level, low oxygen saturation, pulmonary hypertension, heart failure and history of poor nutritional intake.
Objective This study was aimed to described the nutritional status of PDA patient before closure in Hasan
Sadikin General Hospital during January 1, 2021 to June 30, 2021. Methods We conducted retrospective
observational descriptive study in pediatric patients with PDA aged 3 months to 18 years at the pediatric
cardiac clinic during January 1, 2021 to June 30, 2021. All data were collected through secondary data of
medical records. Results Of 60 patients enrolled in this study, there were 30 boys and 30 girls. Based on
PDA classification, there were 17 patients with small PDA, 30 patients with moderate PDA and 13 patients
with large PDA. Based on nutritional status, the incidence of stunting was 41% and malnutrition 18% in
small PDA patients; stunting 73% and malnutrition 27% in moderate PDA patients; 62% stunting and 38%
malnutrition in large PDA patients. Conclusion The highest incidence of stunting was found in moderate
PDA patients while the highest malnutrition was mainly found in large PDA patients.

Keywords: malnutrition; patent ductus arteriosus; stunting

P-CAR-024
Congenital Coronary Artery Fistula with Giant Coronary Artery Aneurysm
and Multiple Cardiac Anomaly: A Case Report

1
Hendra Purnasidha Bagaswoto , Sasmito Nugroho , Noormanto , Indah Kartika Murni 2
2
2
1
2
Pediatric Cardiology Fellow and Department of Child Health , Faculty of Medicine,
Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Central Java, Indonesia
Background A congenital coronary artery fistula (CCAF) with giant coronary artery aneurysm (CAA) is a
rare finding in pediatric cardiac abnormality. This uncommon anomaly is difficult to diagnose by standard
examination such as cardiac auscultation, chest x-ray, or even echocardiography. We report this rare case
which was found incidentally during cardiac catheterization with multiple cardiac anomalies. Objective To
share the challenge of making diagnosis and treatment of the CCAF with giant CAA. Case A 3-month-old
boy was referred to our pediatric cardiology clinics for suspected congenital heart defect based on the presence
of a cardiac murmur and failure to thrive. On general examination, he showed tachypnea and tachycardia.
Cardiac examination revealed continuous murmur in the left second intercostal space. Echocardiography
showed multiple heart defects consisting of small ventricle septal defect (VSD), small patent ductus
arteriosus (PDA), mild aortic stenosis (AS), and pulmonary hypertension. Surprisingly there was no PDA
identified from the cardiac catheterization. However, a giant left CAA (9.3 mm) with RV fistula, aneurysm
of ascending aorta (AA), atrial septal defect (ASD), mild pulmonary stenosis (PS), in addition to the AS and
VSD, were evident. We were planning to do a cardiac CT to confirm these conditions further while waiting
for the device for fistula closure to be available. Unfortunately, a week after being discharged, the parents
informed us that their son has passed away. Conclusion The CCAF is difficult to diagnose and urge early
diagnosis and treatment due to its association with poor prognosis.

Keywords: congenital; coronary artery; fistula; aneurysm

80 KONIKA XVIII Abstract Book