Intervensi Koroner Percutan pada Kegagalan Cangkok Vena Safena: Laporan Kasus
DOI:
https://doi.org/10.24252/alami.v9i1.49954Kata Kunci:
Stenosis Cangkok Vena Saphena, Intervensi Koroner PerkutaneusAbstrak
Penanganan pasien yang terdiagnosis penyakit multivessel arteri koroner utamanya dengan riwayat diabetes saat ini adalah dengan cangkok arteri coroner bypass (CABG) sebagai terapi utama. Cangkok arteri toraks internal secara luas dianggap sebagai cara terbaik untuk merevaskularisasi penyakit arteri koroner lanjut karena bekerja dengan sangat baik dan bertahan lama. Namun, revaskularisasi penuh sulit dicapai dengan hanya penggunaan cangkok arteri saja, sehingga memerlukan cangkok vena saphena (SVG). Namun sebaliknya, SVG tidak memiliki tingkat integritas struktural yang sama, dan malfungsi mereka dikaitkan dengan outcome gejala jantung yang buruk dan tingkat kematian yang lebih tinggi. Pada kasus ini, pasien seorang pria berusia 80 tahun yang memiliki riwayat operasi CABG 13 tahun lalu merasakan nyeri dada yang menjalar hingga ke punggung disertai keringat dingin. Selain diabetes, pasien juga memiliki riwayat hipertensi dan merokok. Pada elektrokardiografi, ditemukan tanda iskemia dan hasil ekokardiogram menunjukkan disfungsi diastolik ringan disertai penurunan fungsi sistolik ventrikel kiri dengan ejection fraction 48%. Hasil laboratorium menunjukkan peningkatan kadar troponin dan peningkatan glukosa darah sewaktu. Setelah dilakukan pemasangan stent dengan drug-eluting stent (DES) pada cangkok vena saphena diagonal, pasien diterapi dengan terapi double antiplatelet, beta-blocker, nitrat, dan statin.
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