Araştırma Makalesi
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BİR ÜNİVERSİTE HASTANESİ KLİNİĞİNDE YAPILAN İLK 200 AÇIK KALP AMELİYATI SONUÇLARI: KIRIKKALE ÜNİVERSİTESİ, TIP FAKÜLTESİ, KALP-DAMAR CERRAHİSİ

Yıl 2020, Cilt: 22 Sayı: 3, 348 - 356, 31.12.2020
https://doi.org/10.24938/kutfd.793704

Öz

Amaç: Çalışmanın amacı, kliniğimizde yapılan ilk 200 açık kalp ameliyatının sonuçlarını değerlendirmektir.
Gereç ve Yöntemler: Yapılan 200 kalp ameliyatı hastane kayıt sistemi taranarak geriye dönük olarak incelendi. Hastaların yaş, cinsiyet, komorbiditeleri, ameliyat tipleri, hastane ve yoğun bakımda yatış süreleri, morbidite ve mortalite oranları değerlendirildi.
Bulgular: Hastaların 128’i kadın,72’si erkekti. Yaşları 38-90 yıl arasında olup, ortalama 68±5 yıldı. Komorbit faktörleri olarak, kronik obstrüktif akciğer hastalığı, hipertansiyon, diabetes mellitus, hiperlipidemi, serebro-vasküler hastalık, periferik arter hastalığı ve kronik böbrek yetmezliği ve miyokart enfarktüsü görüldü. 
Toplam 162 koroner arter bypass grefti (KABG) yapıldı. Bunlardan 24 tanesi çalışan kalpte gerçekleştirildi. Eş zamanlı olarak 5 karotis endarterektomi ve 15 koroner endarterektomi yapıldı. Dört KABG ve mitral kapak replasmanı (MVR), 2 KABG ve aort kapak replasmanı (AVR), 6 AVR, 12 MVR, 4 AVR ve MVR, 3 MVR ve tricuspit anuloplasti yapıldı. İki hastaya aort diseksiyonu nedeniyle asenden aort replasmanı ve 3 hastanın asenden aort anevrizmasına supra koroner aort replasmanı yapıldı. İki hastaya kardiyak yaralanma nedeniyle sağ ventrikül tamiri yapıldı.
Düşük kardiyak debi nedeniyle 10 hastaya intra-aortik balon pompası takıldı. Komplikasyon olarak 38 hastada atrial fibrilasyon, 4 hastada akut böbrek yetmezliği, 3 hastada serebrovaskuler olay gelişti. Hastaların 4’ünde postoperatif kanama ve 3’ünde sternal dehisens nedeniyle revizyon yapıldı. Bir hastada mediastinit görüldü. Yoğun bakımda kalış süresi ortalama 2,2±1,7 gün olup, hastanede kalış süresi 7,5±4 gündü. Hastane mortalitesi 8 hastada (%4) görüldü.
Sonuç: Kırıkkale Üniversitesi Tıp Fakültesi Araştırma ve Uygulama Hastanesi kalp ve damar cerrahisi kliniği, açık kalp ameliyatlarının literatüre uygun morbidite ve mortalite oranları ile yapıldığı bir merkez olmuştur.

Destekleyen Kurum

YOK

Proje Numarası

YOK

Teşekkür

.

Kaynakça

  • 1. Gibbon JH. Application of the mechanical heart and lung aparatus to cardiac surgery, in recent advances in cardiovaskular physiology and surgery minneapolis. Minn Med. 1954;37(5):171-85.
  • 2. Green GE, Stertzer SH, Peppert EH. Coronary arterial bypass grafts. Ann Thorac Surg. 1968;5(1):443-50.
  • 3. Vineberg AM, Miller G. İntenal mamary coronary anastomosis in the surgical treatment of coronary artery unsuffiency. Can Med Assoc. J. 1951;64(9):204-10.
  • 4. Aytaç A. Dünyada ve Türkiye’de kalp cerrahisi. Türk Göğüs Kalp ve Damar Cerrahisi Dergisi. 1991;1(2):8-12.
  • 5. Örer A, Oto Ö. Dünden bugüne kalp cerrahisi. GKDC Dergisi. 1999;7(2):1-6.
  • 6. Swan H, Zeavin I, Blount SC Jr. Virtue RW: Surgery by direct vision in the open heart during hypothermnia. JAMA. 1953;33(6):52-8.
  • 7. Gemalmaz H, Gültekin Y, Hasanov Y. Yeni kurulan bir uluslararası kalp cerrahisi merkezinde yapılan vakaların klinik analizi. Anatolian Curr Med. J 2020;2(4):123-128.
  • 8. Gibbon JH Jr. The development of the heart-lung apparatus. Am J Surg. 1978;135(5):608-19.
  • 9. Lillehei CW, Gott VL, Dewall RA, Varco RL. Surgical correction of pure mitral insufficiency by annuloplasty under direct vision. The Journal-Lancet. 1957;77(11):446-51.
  • 10. Kirklin JW, DuShane JW, Patrick RT, Donald DE, Hetzel PS, Harshbarger HG et al. Intracardiac surgery with the aid of a mechanical pump oxygenator system (Gibbon type): Report of eight cases. Proc Staff Meet Mayo Clin. 1955;30(8):201-11.
  • 11. Hurt R. The history of cardiothoracic surgery. The Parthenon Publishing Group, London, 1996;51(6):312-17.
  • 12. Kuserov BK. A permanently indwelling intracorporeal blood pump to substitute for cardiac function. Trans Am Soc Artif Int Organs. 1958;4(1):227-30.
  • 13. Özbayburtlu M, Gültekin Y, Gemalmaz H. The assessment of the cardioprotective effectiveness of levosimendan on patients with impaired left ventricle functions and less than %40 of ejection fraction who will receive coronary artery bypass graft operation. J Health Sci Med. 2020;3(4):460-65.
  • 14. Köksal C, Sarıkaya S, Özcan V. Zengin M, Meydan B, Helvacı A ve ark. SSK Süreyyapaşa Hastanesi’nde açık kalp cerrahisi: ilk 100 vaka. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2002;10(2):264-6.
  • 15. Kırali K, Güler M, Ekim H, Kutay V, Demirbağ R, Koçak T ve ark. Yeni bir kalp merkezi: Van Yüksek ihtisas Eğitim ve Araştırma Hastanesi: İlk sonuçlar. Turk Gogus Kalp Damar. 2001;9(1):74-8.
  • 16. Büyükateş M, Turan SA, Kandemir Ö, Tokmakoglu H. Zonguldak Karaelmas Üniversitesi Uygulama ve Araştırma Hastanesi’nde açık kalp cerrahisi: ilk 170 olgunun değerlendirilmesi. Turk Gogus Kalp Damar. 2007;15(4):51-4.
  • 17. Tokcan A, Yalınız H. Türkiye’de kalp cerrahisinin tarihçesi. In: Duran E, editör. Kalp ve Damar Cerrahisi. İstanbul: Çapa Tıp Kitabevi; 2004:13-20.
  • 18. Sanon S, Lee VV, Elayda MA, Gondi S, Livesay JJ, Reul GJ et al. Predicting early deathafter cardiovascular surgeryby using the texas heart ınstitute risk scoring technique (THIRST). TexHeartInst J. 2013;40(2):156-62.
  • 19. O’Connor GT, Plume SK, Olmstead EM, Coffin LH, Morton JR, Maloney CT et al. Multivariateprediction of in-hospital mortality associated with coronaryartery bypass graftsurgery. Northern New England Cardiovascular Disease Study Group. Circulation. 1992;85(6):2110-8.
  • 20. Tu JV, Jaglal SB, Naylor CD. Multicenter validation of a risk index for mortality, intensive careunitstay, and overall hospital length of stayafter cardiacsurgery. Steering Committee of the Provincia Adult Cardiac Care Network of Ontario. Circulation. 1995;91(7):677-84.
  • 21. Mangano DT. Perioperative cardiac morbidity. Anesthesiology. 1990;72(11):153-84.
  • 22. Geissler HJ, Hölzl P, Marohl S, Kuhn-Régnier F, Mehlhorn U, Südkamp M et al. Risk stratification in heart surgery: comparison of six score systems. Eur J Cardiothorac Surg. 2000;17(5):400-6.
  • 23. Vogt A, Grube E, Glunz HG, Sechtem U, Mäurer W, Tebbe U et al. Determinants of mortality after cardiac surgery: results of the registry of the Arbeitsgemeinschaft Leitender Kardiologischer Krankenhausärzte (ALKK) on 10 525 patients. Eur Heart J. 2000;21(1):12-20.
  • 24. Dinler G, Bokeria LA, Batyraliev T. Koroner arterlerin stentlenmesinin düşük sol ventrikül ejeksiyon fraksiyonlu hastalarda azalmış miyokart fonksiyonuna etkisi. Türk Girişimsel Kard. Der. 2007;11(3):138-45.
  • 25. Helgadottir S, Sigurdsson MI, Ingvarsdottir IL, Arnar DO, Gudbjartsson T. Atrial fibrillation following cardiac surgery: risk analysis and longterm survival. J Cardiothorac Surg. 2012;7(2):87-94.
  • 26. Hilberman M, Myers BD, Carrie BJ. Acute renal failure following cardiac surgery, J Thorac cardiovasc surg. 1979;77(1):880-8.
  • 27. Bojar RM, Najafi H, DeLaria GA, Serry C, Goldin MD. Neorological complication of coronary revascularization. Ann Thoracic Surg. 1983;36(4):427-32.
  • 28. Shaw PJ, Bates D, Cartlidge NE, Heaviside D, French, Julian DG et al. Neorological complication of coronary artery bypass greft surgery; six month follow up study. Br. Med J. 1986;293(6540):165-7.
  • 29. Breisblatt WM, Stein KL, Wolfe CJ, Follansbee WP, Capozzi J, Armitage JM et al. Acute myocardial dysfunctional and recovery: common occurence after coronary artery bypass, J Am Coll Cardiol. 1990;15(6):1261-9.
  • 30. Smedira NG, Hlozek CC, McCarthy PM. Mechenical support after cardiac surgery. Semin cardiothorac Vasc Anesth. 1998;2(5):66-71.
  • 31. Kollef MH, Sharpless L, Vlasnik J, Pasque C, Murphy D, Fraser VJ et al. The impact of nosocomial ınfections on patient outcomes following cardiac surgery. Chest. 1997;112(3):666-75.
  • 32. Schimmer C, Reents W, Berneder S, Eigel P, Sezer O, Scheld H et al. Prevention of sternal dehiscence and infection in high-risk patients: A prospective randomized multicenter trial. Ann Thorac Surg. 2008;86(6):1897-904.
  • 33. Sjögren J, Malmsjö M, Gustafsson R, Ingemansson R. Poststernotomy mediastinitis: a review of conventional surgical treatments, vacuumassisted closure therapy and presentation of the Lund University Hospital mediastinitis algorithm. Eur J Cardiothorac Surg. 2006;30(3):898-905.
  • 34. Cosgrove DM. Evaluation of perioperative risk factors. J Card Surg 1990;5(1):227-30.

Results of the First 200 Open Heart Surgeries Performed in A University Hospital Clinic: Kırıkkale University, Faculty of Medicine, Cardiovascular Surgery

Yıl 2020, Cilt: 22 Sayı: 3, 348 - 356, 31.12.2020
https://doi.org/10.24938/kutfd.793704

Öz

Objective: The aim of the study is to evaluate the results of the first 200 open heart surgeries performed in our clinic.
Material and Methods: Two hundred heart surgeries performed were analyzed retrospectively by scanning the hospital registry system. Patients' age, gender, comorbidities, types of surgery, hospital stay and intensive care unit stay, morbidity and mortality rates were evaluated.
Results: One hundred and twenty-eight of the patients were women and 72 were men. Their age was between 38-90 years and the mean age was 68±5 years. Comorbid factors included, chronic obstructive pulmonary disease, hypertension, diabetes mellitus, hyperlipidemia, cerebro-vascular disease, peripheral artery disease, chronic renal failure, and myocardial infarction. A total of 162 coronary artery bypass graft (CABG) surgeries were performed and 24 of them were off-pump. Five carotid endarterectomies and 15 coronary endarterectomies were performed simultaneously. Four CABG and mitral valve replacement (MVR), 2 CABG surgery and aortic valve replacement (AVR), 6 AVR, 12 MVR, 4 AVR and MVR, 3 MVR and tricuspid annuloplasty were performed. Ascending aortic replacement was performed in 2 patients due to aortic dissection. A supracoronary aortic replacement was performed to 3 ascending aortic aneurysms. Right ventricle was repaired due to 2 cardiac injuries. Ten intraaortic balloon pumps were inserted due to low cardiac output. Complications were 38 atrial fibrillation, 4 acute renal failure, and 3 cerebro-vascular events. Revision was performed due to 4 postoperative bleeding and 3 sternal dehiscence. Mediastinitis developed in 1 patient. The average length of stay in intensive care unit was 2.2±1.7 days, and the hospital stay was 7.5±4 days. Hospital mortality was seen in 8 (4%).
Conclusion: Kırıkkale University Faculty of Medicine Research and Application Hospital cardiovascular surgery clinic has become a center where open heart surgeries are performed in line with the literature regarding morbidity and mortality rates.

Proje Numarası

YOK

Kaynakça

  • 1. Gibbon JH. Application of the mechanical heart and lung aparatus to cardiac surgery, in recent advances in cardiovaskular physiology and surgery minneapolis. Minn Med. 1954;37(5):171-85.
  • 2. Green GE, Stertzer SH, Peppert EH. Coronary arterial bypass grafts. Ann Thorac Surg. 1968;5(1):443-50.
  • 3. Vineberg AM, Miller G. İntenal mamary coronary anastomosis in the surgical treatment of coronary artery unsuffiency. Can Med Assoc. J. 1951;64(9):204-10.
  • 4. Aytaç A. Dünyada ve Türkiye’de kalp cerrahisi. Türk Göğüs Kalp ve Damar Cerrahisi Dergisi. 1991;1(2):8-12.
  • 5. Örer A, Oto Ö. Dünden bugüne kalp cerrahisi. GKDC Dergisi. 1999;7(2):1-6.
  • 6. Swan H, Zeavin I, Blount SC Jr. Virtue RW: Surgery by direct vision in the open heart during hypothermnia. JAMA. 1953;33(6):52-8.
  • 7. Gemalmaz H, Gültekin Y, Hasanov Y. Yeni kurulan bir uluslararası kalp cerrahisi merkezinde yapılan vakaların klinik analizi. Anatolian Curr Med. J 2020;2(4):123-128.
  • 8. Gibbon JH Jr. The development of the heart-lung apparatus. Am J Surg. 1978;135(5):608-19.
  • 9. Lillehei CW, Gott VL, Dewall RA, Varco RL. Surgical correction of pure mitral insufficiency by annuloplasty under direct vision. The Journal-Lancet. 1957;77(11):446-51.
  • 10. Kirklin JW, DuShane JW, Patrick RT, Donald DE, Hetzel PS, Harshbarger HG et al. Intracardiac surgery with the aid of a mechanical pump oxygenator system (Gibbon type): Report of eight cases. Proc Staff Meet Mayo Clin. 1955;30(8):201-11.
  • 11. Hurt R. The history of cardiothoracic surgery. The Parthenon Publishing Group, London, 1996;51(6):312-17.
  • 12. Kuserov BK. A permanently indwelling intracorporeal blood pump to substitute for cardiac function. Trans Am Soc Artif Int Organs. 1958;4(1):227-30.
  • 13. Özbayburtlu M, Gültekin Y, Gemalmaz H. The assessment of the cardioprotective effectiveness of levosimendan on patients with impaired left ventricle functions and less than %40 of ejection fraction who will receive coronary artery bypass graft operation. J Health Sci Med. 2020;3(4):460-65.
  • 14. Köksal C, Sarıkaya S, Özcan V. Zengin M, Meydan B, Helvacı A ve ark. SSK Süreyyapaşa Hastanesi’nde açık kalp cerrahisi: ilk 100 vaka. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2002;10(2):264-6.
  • 15. Kırali K, Güler M, Ekim H, Kutay V, Demirbağ R, Koçak T ve ark. Yeni bir kalp merkezi: Van Yüksek ihtisas Eğitim ve Araştırma Hastanesi: İlk sonuçlar. Turk Gogus Kalp Damar. 2001;9(1):74-8.
  • 16. Büyükateş M, Turan SA, Kandemir Ö, Tokmakoglu H. Zonguldak Karaelmas Üniversitesi Uygulama ve Araştırma Hastanesi’nde açık kalp cerrahisi: ilk 170 olgunun değerlendirilmesi. Turk Gogus Kalp Damar. 2007;15(4):51-4.
  • 17. Tokcan A, Yalınız H. Türkiye’de kalp cerrahisinin tarihçesi. In: Duran E, editör. Kalp ve Damar Cerrahisi. İstanbul: Çapa Tıp Kitabevi; 2004:13-20.
  • 18. Sanon S, Lee VV, Elayda MA, Gondi S, Livesay JJ, Reul GJ et al. Predicting early deathafter cardiovascular surgeryby using the texas heart ınstitute risk scoring technique (THIRST). TexHeartInst J. 2013;40(2):156-62.
  • 19. O’Connor GT, Plume SK, Olmstead EM, Coffin LH, Morton JR, Maloney CT et al. Multivariateprediction of in-hospital mortality associated with coronaryartery bypass graftsurgery. Northern New England Cardiovascular Disease Study Group. Circulation. 1992;85(6):2110-8.
  • 20. Tu JV, Jaglal SB, Naylor CD. Multicenter validation of a risk index for mortality, intensive careunitstay, and overall hospital length of stayafter cardiacsurgery. Steering Committee of the Provincia Adult Cardiac Care Network of Ontario. Circulation. 1995;91(7):677-84.
  • 21. Mangano DT. Perioperative cardiac morbidity. Anesthesiology. 1990;72(11):153-84.
  • 22. Geissler HJ, Hölzl P, Marohl S, Kuhn-Régnier F, Mehlhorn U, Südkamp M et al. Risk stratification in heart surgery: comparison of six score systems. Eur J Cardiothorac Surg. 2000;17(5):400-6.
  • 23. Vogt A, Grube E, Glunz HG, Sechtem U, Mäurer W, Tebbe U et al. Determinants of mortality after cardiac surgery: results of the registry of the Arbeitsgemeinschaft Leitender Kardiologischer Krankenhausärzte (ALKK) on 10 525 patients. Eur Heart J. 2000;21(1):12-20.
  • 24. Dinler G, Bokeria LA, Batyraliev T. Koroner arterlerin stentlenmesinin düşük sol ventrikül ejeksiyon fraksiyonlu hastalarda azalmış miyokart fonksiyonuna etkisi. Türk Girişimsel Kard. Der. 2007;11(3):138-45.
  • 25. Helgadottir S, Sigurdsson MI, Ingvarsdottir IL, Arnar DO, Gudbjartsson T. Atrial fibrillation following cardiac surgery: risk analysis and longterm survival. J Cardiothorac Surg. 2012;7(2):87-94.
  • 26. Hilberman M, Myers BD, Carrie BJ. Acute renal failure following cardiac surgery, J Thorac cardiovasc surg. 1979;77(1):880-8.
  • 27. Bojar RM, Najafi H, DeLaria GA, Serry C, Goldin MD. Neorological complication of coronary revascularization. Ann Thoracic Surg. 1983;36(4):427-32.
  • 28. Shaw PJ, Bates D, Cartlidge NE, Heaviside D, French, Julian DG et al. Neorological complication of coronary artery bypass greft surgery; six month follow up study. Br. Med J. 1986;293(6540):165-7.
  • 29. Breisblatt WM, Stein KL, Wolfe CJ, Follansbee WP, Capozzi J, Armitage JM et al. Acute myocardial dysfunctional and recovery: common occurence after coronary artery bypass, J Am Coll Cardiol. 1990;15(6):1261-9.
  • 30. Smedira NG, Hlozek CC, McCarthy PM. Mechenical support after cardiac surgery. Semin cardiothorac Vasc Anesth. 1998;2(5):66-71.
  • 31. Kollef MH, Sharpless L, Vlasnik J, Pasque C, Murphy D, Fraser VJ et al. The impact of nosocomial ınfections on patient outcomes following cardiac surgery. Chest. 1997;112(3):666-75.
  • 32. Schimmer C, Reents W, Berneder S, Eigel P, Sezer O, Scheld H et al. Prevention of sternal dehiscence and infection in high-risk patients: A prospective randomized multicenter trial. Ann Thorac Surg. 2008;86(6):1897-904.
  • 33. Sjögren J, Malmsjö M, Gustafsson R, Ingemansson R. Poststernotomy mediastinitis: a review of conventional surgical treatments, vacuumassisted closure therapy and presentation of the Lund University Hospital mediastinitis algorithm. Eur J Cardiothorac Surg. 2006;30(3):898-905.
  • 34. Cosgrove DM. Evaluation of perioperative risk factors. J Card Surg 1990;5(1):227-30.
Toplam 34 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Yıldırım Gültekin 0000-0002-9384-0556

Ali Bolat 0000-0002-2203-8419

Proje Numarası YOK
Yayımlanma Tarihi 31 Aralık 2020
Gönderilme Tarihi 11 Eylül 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 22 Sayı: 3

Kaynak Göster

APA Gültekin, Y., & Bolat, A. (2020). BİR ÜNİVERSİTE HASTANESİ KLİNİĞİNDE YAPILAN İLK 200 AÇIK KALP AMELİYATI SONUÇLARI: KIRIKKALE ÜNİVERSİTESİ, TIP FAKÜLTESİ, KALP-DAMAR CERRAHİSİ. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, 22(3), 348-356. https://doi.org/10.24938/kutfd.793704
AMA Gültekin Y, Bolat A. BİR ÜNİVERSİTE HASTANESİ KLİNİĞİNDE YAPILAN İLK 200 AÇIK KALP AMELİYATI SONUÇLARI: KIRIKKALE ÜNİVERSİTESİ, TIP FAKÜLTESİ, KALP-DAMAR CERRAHİSİ. Kırıkkale Üni Tıp Derg. Aralık 2020;22(3):348-356. doi:10.24938/kutfd.793704
Chicago Gültekin, Yıldırım, ve Ali Bolat. “BİR ÜNİVERSİTE HASTANESİ KLİNİĞİNDE YAPILAN İLK 200 AÇIK KALP AMELİYATI SONUÇLARI: KIRIKKALE ÜNİVERSİTESİ, TIP FAKÜLTESİ, KALP-DAMAR CERRAHİSİ”. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 22, sy. 3 (Aralık 2020): 348-56. https://doi.org/10.24938/kutfd.793704.
EndNote Gültekin Y, Bolat A (01 Aralık 2020) BİR ÜNİVERSİTE HASTANESİ KLİNİĞİNDE YAPILAN İLK 200 AÇIK KALP AMELİYATI SONUÇLARI: KIRIKKALE ÜNİVERSİTESİ, TIP FAKÜLTESİ, KALP-DAMAR CERRAHİSİ. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 22 3 348–356.
IEEE Y. Gültekin ve A. Bolat, “BİR ÜNİVERSİTE HASTANESİ KLİNİĞİNDE YAPILAN İLK 200 AÇIK KALP AMELİYATI SONUÇLARI: KIRIKKALE ÜNİVERSİTESİ, TIP FAKÜLTESİ, KALP-DAMAR CERRAHİSİ”, Kırıkkale Üni Tıp Derg, c. 22, sy. 3, ss. 348–356, 2020, doi: 10.24938/kutfd.793704.
ISNAD Gültekin, Yıldırım - Bolat, Ali. “BİR ÜNİVERSİTE HASTANESİ KLİNİĞİNDE YAPILAN İLK 200 AÇIK KALP AMELİYATI SONUÇLARI: KIRIKKALE ÜNİVERSİTESİ, TIP FAKÜLTESİ, KALP-DAMAR CERRAHİSİ”. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 22/3 (Aralık 2020), 348-356. https://doi.org/10.24938/kutfd.793704.
JAMA Gültekin Y, Bolat A. BİR ÜNİVERSİTE HASTANESİ KLİNİĞİNDE YAPILAN İLK 200 AÇIK KALP AMELİYATI SONUÇLARI: KIRIKKALE ÜNİVERSİTESİ, TIP FAKÜLTESİ, KALP-DAMAR CERRAHİSİ. Kırıkkale Üni Tıp Derg. 2020;22:348–356.
MLA Gültekin, Yıldırım ve Ali Bolat. “BİR ÜNİVERSİTE HASTANESİ KLİNİĞİNDE YAPILAN İLK 200 AÇIK KALP AMELİYATI SONUÇLARI: KIRIKKALE ÜNİVERSİTESİ, TIP FAKÜLTESİ, KALP-DAMAR CERRAHİSİ”. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, c. 22, sy. 3, 2020, ss. 348-56, doi:10.24938/kutfd.793704.
Vancouver Gültekin Y, Bolat A. BİR ÜNİVERSİTE HASTANESİ KLİNİĞİNDE YAPILAN İLK 200 AÇIK KALP AMELİYATI SONUÇLARI: KIRIKKALE ÜNİVERSİTESİ, TIP FAKÜLTESİ, KALP-DAMAR CERRAHİSİ. Kırıkkale Üni Tıp Derg. 2020;22(3):348-56.

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