PROFESIONAL DILEMMA IN FACING

LIMITATION OF HEALTH VALVE IN

DEVELOPING COUNTRIES
The case of expensive artificial heart
valve in developing countries

D1

Adhiwinata Aman (130110100004)

Natanael Parningotan (130110100085)

Ade Triyadi (130110100039)

Okky Husain (130110100056)

Rahmia Lenisa (130110100218)

Yunitasari (130110100007)

Sofwah Nisana (130110100186)

Cindy Regina Putri (130110100174)

Ignatia Ratna (130110100148)

Sheila Sumargo (130110100156)

Overview Heart Valve Replacement

Heart valve surgery used to repair or replace diseased heart
valves.
HOW?
Before your surgery you will receivegeneral anesthesia. In open
surgery, the surgeon makes a large surgical cut in your
breastbone to reach the heart and aorta. Most people are
connected to a heart-lung bypass machine or bypass pump. Your
heart is stopped while you are connected to this machine. This
machine does the work of your heart while your heart is stopped.

If your valve is too damaged, you will need a new valve.

This is called valve replacement surgery. Your surgeon will
remove your valve and put a new one in place.
The main types of new valves are:

Mechanical made of man-made materials

Biological made of human or animal tissue.

In some cases, surgeons can use your own pulmonary valve

to replace the damaged aortic valve. The pulmonary valve
is then replaced with an artificial valve (this is called the
Ross Procedure).

The need of heart valve replacement in

developing country
Tingkat kebutuhan operasi penggantian
katup jantung di negara berkembang
cukup tinggi dibanding negara maju,
karena pemenuhan nutrisi yang masih
belum baik, tingginya angka penyakit
jantung rematik, dan kurangnya kualitas
kesehatan pada masa tua.

The cost of artificial heart valve

replacement
biaya operasi penggantian katup jantung di US
sekitar $14000 sampai $20000, tergantung
rumah sakitnya.
di India biayanya bisa sekitar $9500.
di Indonesia sendiri, biaya penggantian katup
jantung berkisar antara 60 sampai 75 juta rupiah.
Tapi tergantung masing-masing rumah sakit. Bisa
juga mencapai diatas 150 juta rupiah.

What a doctor should say and do when

facing patient who need artificial heart
valve but facing financial difficulty?
Dalam Kode Etik Kedokteran Indonesia dijelaskan pedoman imbalan jasa dokter.
Sebelumnya
(menjelaskan

dokter

harus

kepentingan

melakukan
tindakan

informed
operasi,

consent
alternatif

terlebih
tindakan,

dahulu
dll.).

Selanjutnya diskusikan masalah pembiayaan dengan pasien sebelum dilakukan

tindakan, agar pasien tidak bingung dan tidak cemas.
Pada kasus ini, pasien memiliki masalah finansial, dokter bisa meringankan
biaya jasa atau menghilangkan sama sekali. Untuk biaya alat dan perawatan
rumah sakit menjadi kebijakan RSnya masing masing.
Beritahu juga bahwa pasien bisa menggunakan bantuan jaminan kesehatan
yang disediakan pemerintah untuk meringankan biaya perawatan.