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Sağ Ventrikül Çıkış Yolu Darlıklarının Tamirinde Homogreft ve Contegra Greft Kullanılan Hastaların Sağ Kalımının Karşılaştırılması

Year 2021, Volume: 8 Issue: 1, 135 - 141, 31.12.2020
https://doi.org/10.34087/cbusbed.857969

Abstract

Giriş ve Amaç: Homogreftler veya ksenogreftler sağ ventrikül çıkış yolu (RVOT) darlıklarının tedavisinde günümüzde en sık kullanılan materyallerdir. Çalışmanın amacı RVOT tamirlerinde homogreft ve Contegra® Greft (ksenogreft) kullanılan hastaların mortalite oranlarını belirlemek ve sağ kalımlarını karşılaştırmaktır. Çalışmanın ikincil amacı ise mortalite için risk faktörlerinin belirlenmesidir.
Gereç ve Yöntemler: Çalışmaya üçüncü basamak sağlık kuruluşumuzda son yedi yılda RVOT darlığı nedeniyle homogreft veya Contegra® Greft kullanılarak RVOT rekonstrüksüyonu uygulanan hastalar dahil edilmiştir. Toplam 71 hastanın; 18’ine homogreft (%25,4) ve 53’üne (%74,6) ise Contegra® Greft ile RVOT rekonstrüksüyonu uygulanmıştır. Çalışma için yerel etik kurul izni alınmıştır.
Bulgular: RVOT darlığının en sık etiyolojik sebebi Fallot Tetralojisiydi. Contegra® Greft grubunun yaş ortalaması ve kullanılan greft çapları (t test, p<0,01) daha küçüktü. Grupların kross-klemp ve kardiyopulmoner bypass süreleri, hastanede yatış süreleri benzerdi. Grupların total mortalite oranları arasında farklılık yoktu (Fisher Exact Test, p=0,17). Contegra® Greft grubu için tahmin edilen ortalama sağ kalım süresi 5,6 yılken, homogreft grubunda yaklaşık 4 yıldır. Contegra® Greft grubunda 1 yıllık sağ kalım %88 iken 5 yılda oran %83’e düşmektedir (Kaplan-Meier metodu). Multivariate Cox regresyon analizinde tanı, redo operasyonlar, cinsiyet, vücut yüzey alanı mortalite için risk oluşturmazken, 1 yaş altında olmak mortalite için bağımsız bir risk faktörüydü.
Sonuç: RVOT darlıklarının tamirinde Contegra® Greftler, homogreftlerin iyi bir alternatifidir. Erken ve orta dönemdeki benzer fonksiyonel kapasite ve sağ kalım oranları nedeniyle hastaya uygun homogrefte ulaşılamadığında Contegra® Greftler RVOT rekonstrüksüyonunda güvenle kullanılabilir.

References

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  • 1. Breymann, T, Thies, W.R, Boethig, D, Goerg, R, Blanz, U, Koerfer, R, Bovine valved venous xenografts for RVOT reconstruction: results after 71 implantations, European Journal of Cardiothoracic Surgery, 2002, 21(4), 703-10.
  • 2. Brown, J.W, Ruzmetov, M, Rodefeld, M.D, Vijay, P, Darragh, R.K, Valved bovine jugular vein conduits for right ventricular outflow tract reconstruction in children: an attractive alternative to pulmonary homograft, The Annals of Thoracic Surgery, 2006, 82(3), 909-16.
  • 2. Brown, J.W, Ruzmetov, M, Rodefeld, M.D, Vijay, P, Darragh, R.K, Valved bovine jugular vein conduits for right ventricular outflow tract reconstruction in children: an attractive alternative to pulmonary homograft, The Annals of Thoracic Surgery, 2006, 82(3), 909-16.
  • 3. Boethig, D, Thies, W.R, Hecker, H, Breymann, T, Mid term course after pediatric right ventricular outflow tract reconstruction: a comparison of homografts, porcine xenografts and Contegras, European Journal of Cardiothoracic Surgery, 2005, 27(1), 58-66.
  • 3. Boethig, D, Thies, W.R, Hecker, H, Breymann, T, Mid term course after pediatric right ventricular outflow tract reconstruction: a comparison of homografts, porcine xenografts and Contegras, European Journal of Cardiothoracic Surgery, 2005, 27(1), 58-66.
  • 4. Pearl, J.M, Cooper, D.S, Bove, K.E, Manning, P.B, Early failure of the Shelhigh pulmonary valve conduit in infants, Annals of Thoracic Surgery, 2002, 74(2), 542-8, discussion 548-549.
  • 4. Pearl, J.M, Cooper, D.S, Bove, K.E, Manning, P.B, Early failure of the Shelhigh pulmonary valve conduit in infants, Annals of Thoracic Surgery, 2002, 74(2), 542-8, discussion 548-549.
  • 5. Ross, D.N, Somerville, J, Correction of pulmonary atresia with a homograft aortic valve, Lancet, 1966, 2(7479), 1446-7.
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  • 6. Homann, M, Haehnel, J.C, Mendler, N, Paek, S.U, Holper, K, Meisner, H et al, Reconstruction of the RVOT with valved biological conduits: 25 years experience with allografts and xenografts, European Journal of Cardiothoracic Surgery, 2000, 17(6), 624-30.
  • 6. Homann, M, Haehnel, J.C, Mendler, N, Paek, S.U, Holper, K, Meisner, H et al, Reconstruction of the RVOT with valved biological conduits: 25 years experience with allografts and xenografts, European Journal of Cardiothoracic Surgery, 2000, 17(6), 624-30.
  • 7. Tweddell, J.S, Pelech, A.N, Frommelt, P.C, Mussatto, K.A, Wyman, J.D, Fedderly, R.T, et al, Factors affecting longevity of homograft valves used in right ventricular outflow tract reconstruction for congenital heart disease, Circulation, 2000, 102(19 Suppl 3), III130-135.
  • 7. Tweddell, J.S, Pelech, A.N, Frommelt, P.C, Mussatto, K.A, Wyman, J.D, Fedderly, R.T, et al, Factors affecting longevity of homograft valves used in right ventricular outflow tract reconstruction for congenital heart disease, Circulation, 2000, 102(19 Suppl 3), III130-135.
  • 8. Lange, R, Weipert, J, Homann, M, Mendler, N, Paek, S.U, Holper, K, et al, Performance of allografts and xenografts for right ventricular outflow tract reconstruction, Annals of Thoracic Surgery, 2001, 71(5 Suppl), S365-367.
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  • 9. Meyns, B, Jashari, R, Gewillig, M, Mertens, L, Komárek, A, Lesaffre, E, et al, Factors influencing the survival of cryopreserved homografts. The second homograft performs as well as the first, European Journal of Cardiothoracic Surgery, 2005, 28(2), 211-6, discussion 216.
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  • 10. Javadpour, H, Veerasingam, D, Wood, AE, Calcification of homograft valves in the pulmonary circulation -- is it device or donation related? European Journal of Cardiothoracic Surgery, 2002, 22(1), 78-81.
  • 11. Butany, J, Ahluwalia, M.S, Nair, V, David, T.E, Cryopreserved pulmonary homograft: postimplant changes, Cardiovascular Pathology, 2004, 13(1), 59-61.
  • 11. Butany, J, Ahluwalia, M.S, Nair, V, David, T.E, Cryopreserved pulmonary homograft: postimplant changes, Cardiovascular Pathology, 2004, 13(1), 59-61.
  • 12. Miyazaki T, Yamagishi M, Maeda Y, Taniguchi S, Fujita S, Hongu H, Yaku H, Long-term outcomes of expanded polytetrafluoroethylene conduits with bulging sinuses and a fan-shaped valve in right ventricular outflow tract reconstruction, Annals of Thoracic and Cardiovascular Surgery, 2018, 155(6), 2567-2576.
  • 12. Miyazaki T, Yamagishi M, Maeda Y, Taniguchi S, Fujita S, Hongu H, Yaku H, Long-term outcomes of expanded polytetrafluoroethylene conduits with bulging sinuses and a fan-shaped valve in right ventricular outflow tract reconstruction, Annals of Thoracic and Cardiovascular Surgery, 2018, 155(6), 2567-2576.
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  • 13. Raja, S.G, Contegra conduit: current outcomes and concerns, Expert Review of Cardiovascular Therapy, 2006, 4(5), 721-30.
  • 14. Carrel, T, Bovine valved jugular vein (Contegra) to reconstruct the right ventricular outflow tract, Expert Review of Medical Devices, 2004, 1(1), 11-9.
  • 14. Carrel, T, Bovine valved jugular vein (Contegra) to reconstruct the right ventricular outflow tract, Expert Review of Medical Devices, 2004, 1(1), 11-9.
  • 15. Sierra, J, Christenson, J.T, Lahlaidi, N.H, Beghetti, M, Kalangos, A, Right ventricular outflow tract reconstruction: what conduit to use? Homograft or Contegra? Annals of Thoracic Surgery, 2007, 84(2), 606-10, discussion 610-611.
  • 15. Sierra, J, Christenson, J.T, Lahlaidi, N.H, Beghetti, M, Kalangos, A, Right ventricular outflow tract reconstruction: what conduit to use? Homograft or Contegra? Annals of Thoracic Surgery, 2007, 84(2), 606-10, discussion 610-611.
  • 16. Bové, T, Demanet, H, Wauthy, P, Goldstein, J.P, Dessy, H, Viart, P, et al, Early results of valved bovine jugular vein conduit versus bicuspid homograft for right ventricular outflow tract reconstruction, The Annals of Thoracic Surgery, 2002, 74(2), 536-41.
  • 16. Bové, T, Demanet, H, Wauthy, P, Goldstein, J.P, Dessy, H, Viart, P, et al, Early results of valved bovine jugular vein conduit versus bicuspid homograft for right ventricular outflow tract reconstruction, The Annals of Thoracic Surgery, 2002, 74(2), 536-41.
  • 17. Christenson, J.T, Sierra, J, Colina Manzano, N.E, Jolou, J, Beghetti, M, Kalangos, A, Homografts and xenografts for right ventricular outflow tract reconstruction: long-term results, The Annals of Thoracic Surgery, 2010, 90(4), 1287-93.
  • 17. Christenson, J.T, Sierra, J, Colina Manzano, N.E, Jolou, J, Beghetti, M, Kalangos, A, Homografts and xenografts for right ventricular outflow tract reconstruction: long-term results, The Annals of Thoracic Surgery, 2010, 90(4), 1287-93.
  • 18. Christenson, J.T, Vala, D, Sierra, J, Beghetti, M, Kalangos, A, Blood group incompatibility and accelerated homograft fibrocalcifications, Journal of Thoracic and Cardiovascular Surgery, 2004, 127(1), 242-50. 19. Askovich, B, Hawkins, J.A, Sower, C.T, Minich, L.L, Tani, L.Y, Stoddard, G, et al, Right ventricle-to-pulmonary artery conduit longevity: is it related to allograft size? The Annals of Thoracic Surgery, 2007, 84(3), 907-11, discussion 911-912.
  • 18. Christenson, J.T, Vala, D, Sierra, J, Beghetti, M, Kalangos, A, Blood group incompatibility and accelerated homograft fibrocalcifications, Journal of Thoracic and Cardiovascular Surgery, 2004, 127(1), 242-50. 19. Askovich, B, Hawkins, J.A, Sower, C.T, Minich, L.L, Tani, L.Y, Stoddard, G, et al, Right ventricle-to-pulmonary artery conduit longevity: is it related to allograft size? The Annals of Thoracic Surgery, 2007, 84(3), 907-11, discussion 911-912.
  • 20. Breymann, T, Blanz, U, Wojtalik, M.A, Daenen, W, Hetzer, R, Sarris, G, et al, European Contegra multicentre study: 7-year results after 165 valved bovine jugular vein graft implantations, Thorac Cardiovasc Surg, Ağustos 2009, 57(5), 257-69.
  • 20. Breymann, T, Blanz, U, Wojtalik, M.A, Daenen, W, Hetzer, R, Sarris, G, et al, European Contegra multicentre study: 7-year results after 165 valved bovine jugular vein graft implantations, Thorac Cardiovasc Surg, Ağustos 2009, 57(5), 257-69.
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Comparison of the Survival of Patients who Underwent Right Ventricular Outflow Tract Repair with Homografts Versus Contegra Grafts

Year 2021, Volume: 8 Issue: 1, 135 - 141, 31.12.2020
https://doi.org/10.34087/cbusbed.857969

Abstract

Objective: Homografts or xenografts are the most commonly used materials in the treatment of right ventricular outflow tract (RVOT) stenosis. The aim of the study is to determine the mortality rates and compare the survival rates of patients who underwent RVOT repair by using homograft and Contegra® Graft (xenograft). The secondary endpoint of the study was to determine the risk factors for mortality.
Materials and Methods: We included 71 patients who are operated in last seven years in our tertiary healthcare service for RVOT reconstructions by using homograft or Contegra® Graft. Homograft was applied 18 of them (24.5%) and Contegra® Graft was applied 53 of them (74.6%). Local ethical committee approved the study.
Results: Tetralogy of Fallot was the most common etiological cause of RVOT stenosis. The average age and the graft diameters that used were in smaller size (t test, p <0.0001) in Contegra® Graft group. Cross-clamp and cardiopulmonary bypass times and duration of the hospitalization of the groups were similar. There was no difference between the total mortality rates of the groups (Fisher Exact Test, p = 0.179). The estimated median survival for the Contegra® Graft group is 5.6 years, while in the homograft group it is about 4 years. Survival rates in the Contegra® Graft group, was 88% at 1 year, and the rate decreased to 83% at 5 years (Kaplan-Meier method). In Multivariate Cox regression analysis, the diagnosis, redo operations, gender, body surface area did not pose a risk for mortality, while being under 1 year of age was an independent risk factor for mortality.
Conclusion: Contegra® Graft is a good alternative to homograft for the repair of RVOT obstructions. Because of similar functional capacity and survival rates of the patients in early and mid-term, Contegra® Grafts can be safely used for RVOT reconstruction when a homograft suitable to the patient is not available.

References

  • 1. Breymann, T, Thies, W.R, Boethig, D, Goerg, R, Blanz, U, Koerfer, R, Bovine valved venous xenografts for RVOT reconstruction: results after 71 implantations, European Journal of Cardiothoracic Surgery, 2002, 21(4), 703-10.
  • 1. Breymann, T, Thies, W.R, Boethig, D, Goerg, R, Blanz, U, Koerfer, R, Bovine valved venous xenografts for RVOT reconstruction: results after 71 implantations, European Journal of Cardiothoracic Surgery, 2002, 21(4), 703-10.
  • 2. Brown, J.W, Ruzmetov, M, Rodefeld, M.D, Vijay, P, Darragh, R.K, Valved bovine jugular vein conduits for right ventricular outflow tract reconstruction in children: an attractive alternative to pulmonary homograft, The Annals of Thoracic Surgery, 2006, 82(3), 909-16.
  • 2. Brown, J.W, Ruzmetov, M, Rodefeld, M.D, Vijay, P, Darragh, R.K, Valved bovine jugular vein conduits for right ventricular outflow tract reconstruction in children: an attractive alternative to pulmonary homograft, The Annals of Thoracic Surgery, 2006, 82(3), 909-16.
  • 3. Boethig, D, Thies, W.R, Hecker, H, Breymann, T, Mid term course after pediatric right ventricular outflow tract reconstruction: a comparison of homografts, porcine xenografts and Contegras, European Journal of Cardiothoracic Surgery, 2005, 27(1), 58-66.
  • 3. Boethig, D, Thies, W.R, Hecker, H, Breymann, T, Mid term course after pediatric right ventricular outflow tract reconstruction: a comparison of homografts, porcine xenografts and Contegras, European Journal of Cardiothoracic Surgery, 2005, 27(1), 58-66.
  • 4. Pearl, J.M, Cooper, D.S, Bove, K.E, Manning, P.B, Early failure of the Shelhigh pulmonary valve conduit in infants, Annals of Thoracic Surgery, 2002, 74(2), 542-8, discussion 548-549.
  • 4. Pearl, J.M, Cooper, D.S, Bove, K.E, Manning, P.B, Early failure of the Shelhigh pulmonary valve conduit in infants, Annals of Thoracic Surgery, 2002, 74(2), 542-8, discussion 548-549.
  • 5. Ross, D.N, Somerville, J, Correction of pulmonary atresia with a homograft aortic valve, Lancet, 1966, 2(7479), 1446-7.
  • 5. Ross, D.N, Somerville, J, Correction of pulmonary atresia with a homograft aortic valve, Lancet, 1966, 2(7479), 1446-7.
  • 6. Homann, M, Haehnel, J.C, Mendler, N, Paek, S.U, Holper, K, Meisner, H et al, Reconstruction of the RVOT with valved biological conduits: 25 years experience with allografts and xenografts, European Journal of Cardiothoracic Surgery, 2000, 17(6), 624-30.
  • 6. Homann, M, Haehnel, J.C, Mendler, N, Paek, S.U, Holper, K, Meisner, H et al, Reconstruction of the RVOT with valved biological conduits: 25 years experience with allografts and xenografts, European Journal of Cardiothoracic Surgery, 2000, 17(6), 624-30.
  • 7. Tweddell, J.S, Pelech, A.N, Frommelt, P.C, Mussatto, K.A, Wyman, J.D, Fedderly, R.T, et al, Factors affecting longevity of homograft valves used in right ventricular outflow tract reconstruction for congenital heart disease, Circulation, 2000, 102(19 Suppl 3), III130-135.
  • 7. Tweddell, J.S, Pelech, A.N, Frommelt, P.C, Mussatto, K.A, Wyman, J.D, Fedderly, R.T, et al, Factors affecting longevity of homograft valves used in right ventricular outflow tract reconstruction for congenital heart disease, Circulation, 2000, 102(19 Suppl 3), III130-135.
  • 8. Lange, R, Weipert, J, Homann, M, Mendler, N, Paek, S.U, Holper, K, et al, Performance of allografts and xenografts for right ventricular outflow tract reconstruction, Annals of Thoracic Surgery, 2001, 71(5 Suppl), S365-367.
  • 8. Lange, R, Weipert, J, Homann, M, Mendler, N, Paek, S.U, Holper, K, et al, Performance of allografts and xenografts for right ventricular outflow tract reconstruction, Annals of Thoracic Surgery, 2001, 71(5 Suppl), S365-367.
  • 9. Meyns, B, Jashari, R, Gewillig, M, Mertens, L, Komárek, A, Lesaffre, E, et al, Factors influencing the survival of cryopreserved homografts. The second homograft performs as well as the first, European Journal of Cardiothoracic Surgery, 2005, 28(2), 211-6, discussion 216.
  • 9. Meyns, B, Jashari, R, Gewillig, M, Mertens, L, Komárek, A, Lesaffre, E, et al, Factors influencing the survival of cryopreserved homografts. The second homograft performs as well as the first, European Journal of Cardiothoracic Surgery, 2005, 28(2), 211-6, discussion 216.
  • 10. Javadpour, H, Veerasingam, D, Wood, AE, Calcification of homograft valves in the pulmonary circulation -- is it device or donation related? European Journal of Cardiothoracic Surgery, 2002, 22(1), 78-81.
  • 10. Javadpour, H, Veerasingam, D, Wood, AE, Calcification of homograft valves in the pulmonary circulation -- is it device or donation related? European Journal of Cardiothoracic Surgery, 2002, 22(1), 78-81.
  • 11. Butany, J, Ahluwalia, M.S, Nair, V, David, T.E, Cryopreserved pulmonary homograft: postimplant changes, Cardiovascular Pathology, 2004, 13(1), 59-61.
  • 11. Butany, J, Ahluwalia, M.S, Nair, V, David, T.E, Cryopreserved pulmonary homograft: postimplant changes, Cardiovascular Pathology, 2004, 13(1), 59-61.
  • 12. Miyazaki T, Yamagishi M, Maeda Y, Taniguchi S, Fujita S, Hongu H, Yaku H, Long-term outcomes of expanded polytetrafluoroethylene conduits with bulging sinuses and a fan-shaped valve in right ventricular outflow tract reconstruction, Annals of Thoracic and Cardiovascular Surgery, 2018, 155(6), 2567-2576.
  • 12. Miyazaki T, Yamagishi M, Maeda Y, Taniguchi S, Fujita S, Hongu H, Yaku H, Long-term outcomes of expanded polytetrafluoroethylene conduits with bulging sinuses and a fan-shaped valve in right ventricular outflow tract reconstruction, Annals of Thoracic and Cardiovascular Surgery, 2018, 155(6), 2567-2576.
  • 13. Raja, S.G, Contegra conduit: current outcomes and concerns, Expert Review of Cardiovascular Therapy, 2006, 4(5), 721-30.
  • 13. Raja, S.G, Contegra conduit: current outcomes and concerns, Expert Review of Cardiovascular Therapy, 2006, 4(5), 721-30.
  • 14. Carrel, T, Bovine valved jugular vein (Contegra) to reconstruct the right ventricular outflow tract, Expert Review of Medical Devices, 2004, 1(1), 11-9.
  • 14. Carrel, T, Bovine valved jugular vein (Contegra) to reconstruct the right ventricular outflow tract, Expert Review of Medical Devices, 2004, 1(1), 11-9.
  • 15. Sierra, J, Christenson, J.T, Lahlaidi, N.H, Beghetti, M, Kalangos, A, Right ventricular outflow tract reconstruction: what conduit to use? Homograft or Contegra? Annals of Thoracic Surgery, 2007, 84(2), 606-10, discussion 610-611.
  • 15. Sierra, J, Christenson, J.T, Lahlaidi, N.H, Beghetti, M, Kalangos, A, Right ventricular outflow tract reconstruction: what conduit to use? Homograft or Contegra? Annals of Thoracic Surgery, 2007, 84(2), 606-10, discussion 610-611.
  • 16. Bové, T, Demanet, H, Wauthy, P, Goldstein, J.P, Dessy, H, Viart, P, et al, Early results of valved bovine jugular vein conduit versus bicuspid homograft for right ventricular outflow tract reconstruction, The Annals of Thoracic Surgery, 2002, 74(2), 536-41.
  • 16. Bové, T, Demanet, H, Wauthy, P, Goldstein, J.P, Dessy, H, Viart, P, et al, Early results of valved bovine jugular vein conduit versus bicuspid homograft for right ventricular outflow tract reconstruction, The Annals of Thoracic Surgery, 2002, 74(2), 536-41.
  • 17. Christenson, J.T, Sierra, J, Colina Manzano, N.E, Jolou, J, Beghetti, M, Kalangos, A, Homografts and xenografts for right ventricular outflow tract reconstruction: long-term results, The Annals of Thoracic Surgery, 2010, 90(4), 1287-93.
  • 17. Christenson, J.T, Sierra, J, Colina Manzano, N.E, Jolou, J, Beghetti, M, Kalangos, A, Homografts and xenografts for right ventricular outflow tract reconstruction: long-term results, The Annals of Thoracic Surgery, 2010, 90(4), 1287-93.
  • 18. Christenson, J.T, Vala, D, Sierra, J, Beghetti, M, Kalangos, A, Blood group incompatibility and accelerated homograft fibrocalcifications, Journal of Thoracic and Cardiovascular Surgery, 2004, 127(1), 242-50. 19. Askovich, B, Hawkins, J.A, Sower, C.T, Minich, L.L, Tani, L.Y, Stoddard, G, et al, Right ventricle-to-pulmonary artery conduit longevity: is it related to allograft size? The Annals of Thoracic Surgery, 2007, 84(3), 907-11, discussion 911-912.
  • 18. Christenson, J.T, Vala, D, Sierra, J, Beghetti, M, Kalangos, A, Blood group incompatibility and accelerated homograft fibrocalcifications, Journal of Thoracic and Cardiovascular Surgery, 2004, 127(1), 242-50. 19. Askovich, B, Hawkins, J.A, Sower, C.T, Minich, L.L, Tani, L.Y, Stoddard, G, et al, Right ventricle-to-pulmonary artery conduit longevity: is it related to allograft size? The Annals of Thoracic Surgery, 2007, 84(3), 907-11, discussion 911-912.
  • 20. Breymann, T, Blanz, U, Wojtalik, M.A, Daenen, W, Hetzer, R, Sarris, G, et al, European Contegra multicentre study: 7-year results after 165 valved bovine jugular vein graft implantations, Thorac Cardiovasc Surg, Ağustos 2009, 57(5), 257-69.
  • 20. Breymann, T, Blanz, U, Wojtalik, M.A, Daenen, W, Hetzer, R, Sarris, G, et al, European Contegra multicentre study: 7-year results after 165 valved bovine jugular vein graft implantations, Thorac Cardiovasc Surg, Ağustos 2009, 57(5), 257-69.
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There are 47 citations in total.

Details

Primary Language Turkish
Subjects Surgery, Cardiovascular Surgery
Journal Section Araştırma Makalesi
Authors

Dilşad Amanvermez Şenarslan 0000-0002-3316-6707

Emin Alp Alayunt This is me 0000-0003-4284-0289

Publication Date December 31, 2020
Published in Issue Year 2021 Volume: 8 Issue: 1

Cite

APA Amanvermez Şenarslan, D., & Alayunt, E. A. (2020). Sağ Ventrikül Çıkış Yolu Darlıklarının Tamirinde Homogreft ve Contegra Greft Kullanılan Hastaların Sağ Kalımının Karşılaştırılması. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 8(1), 135-141. https://doi.org/10.34087/cbusbed.857969
AMA Amanvermez Şenarslan D, Alayunt EA. Sağ Ventrikül Çıkış Yolu Darlıklarının Tamirinde Homogreft ve Contegra Greft Kullanılan Hastaların Sağ Kalımının Karşılaştırılması. CBU-SBED: Celal Bayar University-Health Sciences Institute Journal. December 2020;8(1):135-141. doi:10.34087/cbusbed.857969
Chicago Amanvermez Şenarslan, Dilşad, and Emin Alp Alayunt. “Sağ Ventrikül Çıkış Yolu Darlıklarının Tamirinde Homogreft Ve Contegra Greft Kullanılan Hastaların Sağ Kalımının Karşılaştırılması”. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 8, no. 1 (December 2020): 135-41. https://doi.org/10.34087/cbusbed.857969.
EndNote Amanvermez Şenarslan D, Alayunt EA (December 1, 2020) Sağ Ventrikül Çıkış Yolu Darlıklarının Tamirinde Homogreft ve Contegra Greft Kullanılan Hastaların Sağ Kalımının Karşılaştırılması. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 8 1 135–141.
IEEE D. Amanvermez Şenarslan and E. A. Alayunt, “Sağ Ventrikül Çıkış Yolu Darlıklarının Tamirinde Homogreft ve Contegra Greft Kullanılan Hastaların Sağ Kalımının Karşılaştırılması”, CBU-SBED: Celal Bayar University-Health Sciences Institute Journal, vol. 8, no. 1, pp. 135–141, 2020, doi: 10.34087/cbusbed.857969.
ISNAD Amanvermez Şenarslan, Dilşad - Alayunt, Emin Alp. “Sağ Ventrikül Çıkış Yolu Darlıklarının Tamirinde Homogreft Ve Contegra Greft Kullanılan Hastaların Sağ Kalımının Karşılaştırılması”. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 8/1 (December 2020), 135-141. https://doi.org/10.34087/cbusbed.857969.
JAMA Amanvermez Şenarslan D, Alayunt EA. Sağ Ventrikül Çıkış Yolu Darlıklarının Tamirinde Homogreft ve Contegra Greft Kullanılan Hastaların Sağ Kalımının Karşılaştırılması. CBU-SBED: Celal Bayar University-Health Sciences Institute Journal. 2020;8:135–141.
MLA Amanvermez Şenarslan, Dilşad and Emin Alp Alayunt. “Sağ Ventrikül Çıkış Yolu Darlıklarının Tamirinde Homogreft Ve Contegra Greft Kullanılan Hastaların Sağ Kalımının Karşılaştırılması”. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, vol. 8, no. 1, 2020, pp. 135-41, doi:10.34087/cbusbed.857969.
Vancouver Amanvermez Şenarslan D, Alayunt EA. Sağ Ventrikül Çıkış Yolu Darlıklarının Tamirinde Homogreft ve Contegra Greft Kullanılan Hastaların Sağ Kalımının Karşılaştırılması. CBU-SBED: Celal Bayar University-Health Sciences Institute Journal. 2020;8(1):135-41.