This Friday, 21st October 2022, in commemoration of World Heart Day, RSUP Dr. Sardjito alongside National Taiwan University Hospital (NTUH) held a Joint Webinar on “Comprehensive Approach to Critical Congenital Heart Disease”. This webinar is the second of this year in collaboration with NTUH as part of the sister hospital program. In implementing the Transformation of Referral Health Services agenda of the Indonesian Ministry of Health, Dr. Sardjito General Hospital is committed to improve the early detection, referral, and diagnosis of critical congenital heart disease to achieve better outcomes, reducing infant morbidity and mortality. This webinar serves to share the scientific knowledge and expertise in pediatric cardiology from both leading institutions in Indonesia and Taiwan respectively, following the service excellence in pediatric care.
The President Director of Dr. Sardjito General Hospital, represented by the Director of Human Resources Development, Education, and Research, drg. Nusati Ikawahju, M.Sc., opened the webinar with a short speech. Prof. Chia-Yu Chu, MD. PhD. as the Director of International Medical Services Center, NTUH also greeted the participants. The key speakers from Dr. Sardjito General Hospital include Dr. Indah Kartika Murni, PhD, Sp.A(K) and dr. Nadya Arafuri, M.Sc., SpA(K) as Pediatric Cardiologist Consultants, and dr. Alifah Anggraini, M.Sc., SpA(K) as Neonatologist Consultant, with dr. Sasmito Nugroho, SpA(K) as moderator. From NTUH, we heard from Prof. Ming-Tai Lin as Deputy Chair of Pediatrics Department and Professor of Pediatric Cardiology of NTUCH.
The first speech was by Indah Kartika Murni, M.Kes. PhD, Sp.A(K), Pediatric Cardiology Division, Department of Pediatrics, Dr. Sardjito General Hospital Yogyakarta, titled “Screening of Critical Congenital Heart Disease Among Neonates”. As we all know that Critical Congenital Heart Disease (CCHD) stands for any potentially life-treatening duct-dependent disorder from which infants die or undergo invasive procedures (surgery or cardiac catheterazion) in the first 28 days of life. Pulse oximetry screening can be considered as a standard vital sign among neonates by perform at 24-48 hours of age or just before discharge and use 2 limb screening (right hand and foot). Screening of critical CHD in neonates need to be implemented even in setting with limited resources to prevent late diagnosis and further complications.
dr. Alifah Anggraini, MSc, Sp.A(K) from Neonatology Division, Department of Pediatrics, Dr. Sardjito General Hospital Yogyakarta as the second speaker presented on “How to Refer Neonates with Suspected Critical Congenital Heart Disease”. The most critical form of CHD have an additional element of instability with the perinatal transition so they require emergent stabilization and intervention in the first hours after delivery. Besides that, dr. Alifah also presented about the perinatal management strategies to optimize postnatal transition, delivery room management and the initial stabilization.
The 3rd speech came by dr. Nadya Arafuri, M.Sc., Sp. A(K) from Pediatric Cardiology Division, Department of Pediatrics, Dr. Sardjito General Hospital with the topic of “Diagnostic Approach of Critical Congenital Heart Diseases”. Her presentation gave us insight about how delayed diagnosis of CCHD is associated with higher mortality and morbidity. Fetal echocardiography can be used for prenatal diagnosis, but some cases of Critical Congenital Heart Disease (CCHD) are not detected prenatally. Pulse oximetry screening for critical CHD is suggested for all newborns but does not detect all CCHD. Furthermore, postnatal diagnosis may be suspected based on history, physical findings, pulse oximetry screening, chest radiography, and/or electrocardiogram (RCG) findings. At last, the diagnosis is confirmed with echocardiography.
Ming Tai Lin, MD, PhD, Professor of Pediatric Cardiology, Deputy Chair, Department of Pediatrics National Taiwan University Children’s Hospital as the last speaker gave a presentation on the topic “Interventions for Critical CHD, Experiences of NTUCH”. He gave the quick introduction and status of Critical Congenital Heart Disease in Taiwan. Here in after, he also told us about the first target of certain Critical Congenital Heart Disease after Prostaglandin E1 (PGE1) : Valve, Tetralogy of Fallot by PDA stenting and RVOT stenting in NTUCH and Pulmonary atresia with intact ventricular septum by Valvotomy, PDA stenting and Balloon Atrial Septostomy (BAS).