{"id":8144,"date":"2025-02-28T06:00:39","date_gmt":"2025-02-28T03:00:39","guid":{"rendered":"https:\/\/drhasankasap.com\/?p=8144"},"modified":"2025-09-02T00:42:36","modified_gmt":"2025-09-01T21:42:36","slug":"kardiyolojide-kilometre-taslari","status":"publish","type":"post","link":"https:\/\/drhasankasap.com\/index.php\/2025\/02\/28\/kardiyolojide-kilometre-taslari\/","title":{"rendered":"Kardiyoloji’de Kilometre Ta\u015flar\u0131"},"content":{"rendered":"\t\t
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KARD\u0130YOLOJ\u0130DE K\u0130LOMETRE TA\u015eLARI<\/h2>

(Foto\u011fraflar\u0131n \u00fczerine t\u0131klayarak b\u00fcy\u00fctebilirsiniz)<\/em><\/p>

\"\"<\/a><\/p>

1895 : Wilhelm Konrad Roentgen<\/a>, X-\u0131\u015f\u0131nlar\u0131n\u0131 ke\u015ffetti. \u0130lk olarak e\u015finin kol radyografisini \u00e7ekti.Koroner giri\u015fimler X-\u0131\u015f\u0131n\u0131 alt\u0131nda yap\u0131ld\u0131\u011f\u0131ndan Roentgen\u2019in bu bulu\u015fu \u201cgiri\u015fimsel kardiyolojinin\u201d ilk ad\u0131m\u0131 say\u0131lmal\u0131d\u0131r. W.K.Roentgen, 1901 y\u0131l\u0131nda bu ke\u015fif sayesinde Nobel \u00f6d\u00fcl\u00fc alm\u0131\u015ft\u0131r.<\/p>

\"\"<\/a><\/p>

1929 : <\/strong>Werner Forsmann, 65 cm’lik bir kateter ile \u00f6n kol damar\u0131ndan girerek, x-\u0131\u015f\u0131n\u0131 alt\u0131nda, kendi kalbininin g\u00f6r\u00fcnt\u00fcs\u00fcn\u00fc elde etti.(15)<\/p>

1929 : <\/strong>Santos, lumber aortaya kontrast madde enjekte ederek aortay\u0131, x-\u0131\u015f\u0131n\u0131 alt\u0131nda g\u00f6r\u00fcnt\u00fcledi. B\u00f6ylece diagnostik radyolojinin ilk ad\u0131mlar\u0131n\u0131 att\u0131.(16)<\/p>

1938 :<\/strong> Robb ve Steinberg kalp ve santral dola\u015f\u0131m sistemini g\u00f6sterdi ve aortaya kontrast madde enjekte edilerek x-ray alt\u0131nda g\u00f6r\u00fcnt\u00fcledi. (17)<\/p>

1939 :<\/strong> Castellanos ve Pereiras brakial arter yoluyla, retrograd olarak, kontrast madde kullan\u0131larak aortagram tekni\u011fini tarif etti.(18)<\/p>

1940 :<\/strong> Cournand ve Richards sa\u011f kalp fizyolojisine ait\"\"<\/a><\/strong> \u00e7al\u0131\u015fmalar\u0131 yay\u0131nland\u0131.(19)<\/p>

\u00a0<\/strong><\/p>

1941 :<\/strong> Cournand ve arkada\u015flar\u0131 ile Richards ve arkada\u015flar\u0131 ilk tan\u0131sal kalp kateter uygulamas\u0131n\u0131 ger\u00e7ekle\u015ftirdi.(20,21)<\/p>

\"\"<\/a>1948 :<\/strong> Radner, bilek atardamar\u0131 ( radial arter ) yolu ile aortan\u0131n g\u00f6\u011f\u00fcste kalan k\u0131sm\u0131n\u0131 g\u00f6r\u00fcnt\u00fcledi (retrograde torasik aortografi).(22) Bug\u00fcn kullan\u0131m s\u0131kl\u0131\u011f\u0131 gittik\u00e7e artmakta olan ve hasta i\u00e7in koroner anjiyografiyi daha konforlu hale getiren giri\u015f y\u00f6nteminin temellerini atm\u0131\u015f oldu. ( Bu giri\u015f y\u00f6ntemi ile ilk koroner anjiyografi 1989\u2019da Campeau ve arkada\u015flar\u0131 taraf\u0131ndan(23), ilk anjiyoplasti i\u015flemi ise 1993\u2019te Kiemeneij ve arkada\u015flar\u0131(24) taraf\u0131ndan yap\u0131lm\u0131\u015ft\u0131r. \u00dclkemizde ise, bu yolla ilk koroner anjiyografi Nisan 2005 te Prof.Dr. Ferhan \u00d6zmen taraf\u0131ndan yap\u0131ld\u0131.)<\/p>

\"\"<\/a><\/strong><\/p>

1950 :<\/strong> Charles Dotter, kalp kateterizasyonunu klinik uygulamaya soktu.(25) Zimmerman ve Lason, sol-sa\u011f kalp kateterizasyonu uygulad\u0131.(26,27)<\/p>

\u00a0<\/strong><\/p>

\"\"<\/a>1953 :<\/strong> Koroner anjiyografi i\u00e7in kas\u0131k atardamar\u0131ndan giri\u015f y\u00f6ntemi ilk olarak Sven Seldinger<\/a> taraf\u0131ndan geli\u015ftirildi.(28) Y\u00f6ntem, bug\u00fcn de onun ad\u0131yla bilinmektedir. (Bu y\u00f6ntemle ilk koroner anjiyografi 1967\u2019de Judkins taraf\u0131ndan yap\u0131ld\u0131) Bug\u00fcn en s\u0131k kullan\u0131lan y\u00f6ntem Seldinger y\u00f6ntemidir.<\/p>

\"\"<\/a>1954 :<\/strong> T\u00fcrkiye’de ilk sa\u011f kalp kateterizasyonu ; Prof.Dr. Celal Ertu\u011f<\/p>

\u00a0<\/strong><\/p>

\u00a0<\/p>

\"\"<\/a>1956 :<\/strong> Forssmann, Cournand ve Richards, kalp kateterizasyonuna katk\u0131lar\u0131 nedeniyle Nobel \u00d6d\u00fcl\u00fc ald\u0131.(29)<\/p>

\u00a0<\/p>

1958 :<\/strong> Mason Sones<\/a>, Cleveland’ta aortaya kontrast madde injekte etti ve koroner damarlar\u0131 X-\u0131\u015f\u0131n\u0131 alt\u0131nda g\u00f6r\u00fcnt\u00fcledi. Yine 1958 de, kazaen koroner arter i\u00e7ine, kontrast madde injekte ederek koroner arterleri direkt olarak g\u00f6r\u00fcnt\u00fcledi.<\/p>

\"\"<\/a>1959 :<\/strong> Sones, kendi koroner damarlar\u0131n\u0131 g\u00f6stererek, ilk selektif koroner anjiyografiyi yapt\u0131. Bu, modern vask\u00fcler tekniklerinin geli\u015fmesine ve giri\u015fimsel kardiyolojinin do\u011fmas\u0131na neden olmu\u015ftur.(30,31) Ayn\u0131 zamanda a\u00e7\u0131k kalp cerrahisinin geli\u015fiminin de kilometre ta\u015f\u0131d\u0131r. Sones, bu i\u015flemde giri\u015f yeri olarak brakiyal arteri ( \u00f6n kol atardamar\u0131n\u0131) kulland\u0131 ve bu y\u00f6ntem kendi ad\u0131 ile an\u0131ld\u0131 (Sones Y\u00f6ntemi)<\/p>

\"\"<\/a>1962 :<\/strong> T\u00fcrkiye’de ilk sol kalp kateterizasyonu ; Prof.Dr. Turhan Akyol<\/p>

1962 :<\/strong> Ricketts ve Abrams ucuna \u015fekil verilmi\u015f kateterler ( boyay\u0131c\u0131 maddenin i\u00e7inden g\u00f6nderildi\u011fi \u00f6zel i\u00e7i bo\u015f kablolar) kullanarak, koroner anjiyografiyi geli\u015ftirdiler.(32)<\/p>

1964 :<\/strong> \u0130lk perk\u00fctan transluminal angioplastiyi ( deriden girerek damar i\u00e7inden m\u00fcdahale ile damar\u0131 a\u00e7ma i\u015flemi ) periferik arterlerde Charles Dotter<\/a> yapt\u0131. C. Dotter, t\u0131kal\u0131 iliyak damarlar\u0131 kateter ile geni\u015fletti. \u0130liyak damar\u0131n daralm\u0131\u015f k\u0131sm\u0131ndan k\u0131lavuz tel’i (guide wire) ge\u00e7irdikten sonra, dilatasyon kateteri ile damar l\u00fcmenini geni\u015fletti. Hastan\u0131n gangrene gitmekte olan baca\u011f\u0131n\u0131n sekiz ay sonra iyile\u015fti\u011fi g\u00f6zlendi.(33) \u0130lk transluminal angioplasti vaka serisini Dotter ve Judkins 1964 de yay\u0131nland\u0131.<\/p>

\"\"<\/a>1967 :<\/strong> Dr. Melvin Paul Judkins<\/a>, bug\u00fcn en s\u0131k kulland\u0131\u011f\u0131m\u0131z, kendi ad\u0131 ile an\u0131lan, ucuna \u015fekil verilmi\u015f kateterleri geli\u015ftirerek koroner anjiyografiyi daha kolay ve pratik hale getirdi.(34) Hatta Judkins\u2019e atfedilen \u015fu s\u00f6z me\u015fhur olmu\u015ftur: \u201c Operat\u00f6r engel olmazsa, kataterlerim kendi yolunu bulur\u201d<\/p>

1969 :<\/strong> C.Dotter, ilk kez arteriyel endoprotezleri tasarlad\u0131 ve sundu. (35)<\/p>

1970 :<\/strong> Abele, Bentoff ve Myler prototip koroner dilatat\u00f6r ( geni\u015fletici ) kateter geli\u015ftirdi.<\/p>

1972 :<\/strong> T\u00fcrkiye\u2019de ilk koroner anjiyografi Sones y\u00f6ntemi kullan\u0131larak Prof.Dr.Mehmet \u00d6zdemir taraf\u0131ndan yap\u0131ld\u0131.<\/p>

\"\"<\/a>1973 :<\/strong> Koroner anjiyoplastide ilk ara\u00e7 balon kateterdir. Werner Porstmann ucunda latex balonu bulunan kateteri tarif etti. (36)<\/p>

\u00a0<\/p>

\"\"<\/a>1974 :<\/strong> Andreas Gruentzig<\/a> periferik arterlerde kullan\u0131lmak \u00fczere yeni balon dilatasyon kateterleri geli\u015ftirdi.(37)Bu balonlar\u0131n kullan\u0131labilirli\u011fini koroner ve renal arterlere kadar geli\u015ftirdi.(38) 50 vakal\u0131k ilk serisini 1979\u2019da sundu.(39)<\/p>

\u00a0<\/p>

\"\"<\/a><\/strong><\/p>

1975 :<\/strong> T\u00fcrkiye\u2019de Seldinger ( kas\u0131k atardamar\u0131ndan ) giri\u015f y\u00f6ntemi kullan\u0131larak ilk koroner anjiyografi, Prof.Dr.Oral Pekta\u015f taraf\u0131ndan yap\u0131ld\u0131.<\/p>

\u00a0<\/p>

1976 :<\/strong> A.Gruentzig k\u00f6peklerde ve insanlarda kadavrada periferal balon kateter \u00e7al\u0131\u015fmalar\u0131 yapt\u0131(40,41) Ayn\u0131 y\u0131l bu geli\u015ftirilen kateterler ile insan kadavras\u0131nda ilk kez koroner damarlar\u0131n dilatasyonu m\u00fcmk\u00fcn oldu. Gruentzig aterosklerotik pla\u011f\u0131n (damar\u0131 daraltan yap\u0131n\u0131n) bas\u0131n\u00e7la s\u0131k\u0131\u015ft\u0131r\u0131lmas\u0131n\u0131n anjiyoplastinin temel mekanizmas\u0131 oldu\u011funa inanm\u0131\u015f ve pla\u011f\u0131 k\u0131rmak i\u00e7in 6-16 atm. bas\u0131n\u00e7ta \u015fi\u015firilen balon ile daralm\u0131\u015f b\u00f6lgenin geni\u015fletilebilece\u011fini s\u00f6ylemi\u015ftir.<\/p>

1976 :<\/strong> E.L.Chazov ve arkada\u015flar\u0131 akut miyokard infarkt\u00fcs\u00fcnde koroner damar i\u00e7ine p\u0131ht\u0131 eritici tedavinin ( trombolitik tedavi ) ba\u015far\u0131l\u0131 oldu\u011funu rapor etti.(42)<\/p>

1977 :<\/strong> A.Gruentzig, Myler, Hanna ve Turina, May\u0131s 1977\u2019de San Francisco’da, insanda ilk kez intraoperatif koroner anjiyoplastiyi yapt\u0131(43) Bu giri\u015fimi, planl\u0131 \u00e7ok-damar bypass cerrahisi s\u0131ras\u0131nda, ameliyathanede yapt\u0131lar. Safen ven bypass grefti (bypass i\u00e7in al\u0131nan, ayak toplardamar\u0131) konulmadan \u00f6nce arteriyotomi (bacak toplar damar\u0131n\u0131 ba\u011flamak i\u00e7in aort damar\u0131nda a\u00e7\u0131lan k\u00fc\u00e7\u00fck kesi) yerinden k\u0131sa balon kateter kullanarak i\u015flemi ger\u00e7ekle\u015ftirdiler. Bu uygulamada ama\u00e7, plakla daralan damar\u0131n a\u00e7\u0131l\u0131p a\u00e7\u0131lmad\u0131\u011f\u0131n\u0131 ve damar\u0131n devam\u0131ndaki k\u0131s\u0131mlar\u0131na p\u0131ht\u0131 at\u0131l\u0131m\u0131n\u0131n olup olmayaca\u011f\u0131n\u0131 g\u00f6rmek idi. Sonu\u00e7ta damar\u0131n a\u00e7\u0131ld\u0131\u011f\u0131 ve p\u0131ht\u0131 at\u0131l\u0131m\u0131n\u0131n da olmad\u0131\u011f\u0131 g\u00f6zlendi.<\/p>

1977 :<\/strong> May\u0131s 1977\u2019deki \u00e7al\u0131\u015fmalar \u0131\u015f\u0131\u011f\u0131nda, insanda, ilk perk\u00fctan transluminal koroner anjiyoplasti (deriden girilip, damar i\u00e7inden ilerleyerek t\u0131kal\u0131 damar\u0131 a\u00e7ma i\u015flemi), 16 Eyl\u00fcl 1977\u2019de Z\u00fcrihte, Andreas Gruentzig, taraf\u0131ndan, minyat\u00fcrize bir balon kullan\u0131larak yap\u0131ld\u0131(44). (T\u00fcrkiyede ilk koroner anjiyoplasti 1983’te Prof.Dr.Oral Pekta\u015f, Do\u00e7.Dr. Yal\u00e7\u0131n S\u00f6z\u00fctek taraf\u0131ndan). Anjiyoplasti, ba\u015flang\u0131\u00e7ta k\u0131sa, tek damara yerle\u015fik koroner darl\u0131klara uygulan\u0131rken, 1980’den itibaren \u00e7ok-damar hastal\u0131\u011f\u0131na da uygulanmaya ba\u015fland\u0131. Devam eden y\u0131llarda, kronik tam t\u0131kan\u0131kl\u0131klarda ve kalp krizlerinde de uygulama alan\u0131 bulmaya ba\u015flad\u0131.<\/p>

1978 :<\/strong> Rentrop ve arkada\u015flar\u0131 koroner p\u0131ht\u0131 eritici \u201cstreptokinaz\u201d uygulamas\u0131 rapor etti.(45)<\/p>

1980 :<\/strong> Periferik self-expandable ve balon expandable stentler 1980 y\u0131l\u0131nda geli\u015ftirildi. 1980 sonlar\u0131nda koroner arterler i\u00e7in kullan\u0131lmak \u00fczere modifiye edildi.<\/p>

1982 :<\/strong> Simpson ve arkada\u015flar\u0131nca over-the-wire steerable (tel \u00fczerinden y\u00f6nlendirilen) kateter sisteminin uygulamaya ba\u015flanmas\u0131 ile kateter teknolojisinde \u00f6nemli ilerlemeler oldu ve u\u00e7 k\u0131sma do\u011fru giderek incelen, g\u00fc\u00e7l\u00fc materyalden yap\u0131lm\u0131\u015f y\u00fcksek \u015fi\u015firme bas\u0131nc\u0131na izin veren d\u00fc\u015f\u00fck profilli balonlar \u00fcretildi.(46) Sonraki y\u0131llarda da balon teknolojisi, kullan\u0131lan malzeme, uygulama teknikleri a\u00e7\u0131s\u0131ndan s\u00fcrekli geli\u015fmi\u015f ve pratikle\u015fmi\u015ftir.<\/p>

\"\"<\/a>1982 :<\/strong> Akut miyokard infarkt\u00fcs\u00fcnde ilk direkt koroner balon anjiyoplasti (primer anjiyoplasti) Geoffrey O. Hartzler taraf\u0131ndan yap\u0131ld\u0131.(47) (Turkiyede, akut miyokard infarkt\u00fcs\u00fcnde ilk direkt koroner balon anjiyoplasti Prof.Dr Ferhan \u00d6ZMEN taraf\u0131ndan uygulanm\u0131\u015ft\u0131r)<\/p>

1982 :<\/strong> Giri\u015fimsel i\u015flemlerle u\u011fra\u015fan kardiyologlar i\u00e7in ilk tedavi k\u0131lavuzu haz\u0131rland\u0131, 1984’te yay\u0131nland\u0131.(48,49) ( T\u00fcrkiye\u2019de ilk k\u0131lavuz ise, 1988 y\u0131l\u0131nda. )<\/p>

1983 :<\/strong> T\u00fcrkiyede ilk koroner anjiyoplasti; Prof.Dr.Oral Pekta\u015f, Do\u00e7.Dr.Yal\u00e7\u0131n S\u00f6z\u00fctek.<\/p>

1984 :<\/strong> A. Gruentzig se\u00e7ilmi\u015f vakalarda anjioplasti sonu\u00e7lar\u0131n\u0131n koroner by-pass sonu\u00e7lar\u0131na parelel oldu\u011funu yay\u0131nlam\u0131\u015ft\u0131r.(50)<\/p>

1985 :<\/strong> Anjiyoplasti, hafif \u015fikayetleri olan hastalarda ila\u00e7 tedavisine alternatif hale geldi. \u0130laca cevaps\u0131z hastalarda by-pass cerrahisine alternatif oldu\u011fu s\u00f6ylenmeye ba\u015fland\u0131.(51,52)<\/p>

\"\"<\/a>1985 :<\/strong> Julio Palmaz<\/a> balona monte edilmi\u015f stenti k\u00f6pek periferik damarlar\u0131na yerle\u015ftirdi. K\u00f6pek koronerlerinde ba\u015far\u0131l\u0131 balon expandable stenti Schatz bildirdi.(53)<\/p>

1986 :<\/strong> \u00c7ok-damar hastal\u0131\u011f\u0131nda by-pass cerrahisi ile anjiyoplastiyi mukayese eden \u00e7ok merkezli \u00e7al\u0131\u015fmalar\u0131n haz\u0131rl\u0131klar\u0131na ba\u015fland\u0131.<\/p>

1986 :<\/strong> 1983’te Cedars Sinai Hastanesinde ba\u015flayan laser aterektomi uygulamalar\u0131, Excimer laserin kullan\u0131ld\u0131\u011f\u0131 vakalalarla 1986\u2019da tebli\u011f edildi. (54) Excimer Laser aterom pla\u011f\u0131n\u0131 buharla\u015ft\u0131rarak etkisini g\u00f6sterir.(55) (T\u00fcrkiye\u2019de ilk lazer,1997\u2019de Prof.Dr.Servet \u00d6zt\u00fcrk taraf\u0131ndan.)<\/p>

\"\"<\/a>1986 :<\/strong> Jacques Puel ve Ulrich Sigwart<\/a> “wall” stenti, ilk olarak insanda intrakoroner kulland\u0131. (56) (T\u00fcrkiyede ilk stent 1991’de Do\u00e7.Dr. Tu\u011frul Okay taraf\u0131ndan)<\/p>

1987 :<\/strong> Schatz, k\u00f6pek koronerlerinde ba\u015far\u0131l\u0131 balon expandable ( balona monte, balon ile geni\u015fletilen) stenti bildirdi. (57)<\/p>

\"\"<\/a>1988 :<\/strong> Richard Schatz, ilk Palmaz-Schatz stentleri koroner kullan\u0131m\u0131nda antiplatelet tedavinin koroner trombozu \u00f6nleyebilece\u011fini iddia etmesine ra\u011fmen subakut okl\u00fczyon s\u0131kl\u0131\u011f\u0131n\u0131n y\u00fcksek olmas\u0131 intrakoroner stent uygulamalar\u0131n\u0131n duraksamas\u0131nda neden oldu. (58)<\/p>

1988 :<\/strong> \u0130lk ba\u015far\u0131l\u0131 \u201cdireksiyonel aterektomi\u201d(dakikada 5000 devir ile d\u00f6nerek haznesine oturan aterosklerotik pla\u011f\u0131 kesmeye yarayan bir sistem) , John B.Simpson taraf\u0131ndan California\u2019da yap\u0131ld\u0131.(59) (T\u00fcrkiyede ilk aterektomiyi 1991\u2019de Prof.Dr. Mustafa AKIN) (70) Bug\u00fcn i\u00e7in direksiyonel aterektomi, rotasyonel aterektomi (rotablator) ve laser aterektomi, restenoz (yeniden daralma) y\u00f6n\u00fcnden istenilen sonucu vermedi\u011finden, restenoz oranlar\u0131 daha y\u00fcksek oldu\u011fundan klinikte kullan\u0131mlar\u0131 s\u0131n\u0131rl\u0131d\u0131r. (70)<\/p>

1991 :<\/strong> Cutting balon (kesici balon) y\u00f6ntemi ilk kez Barath taraf\u0131ndan uyguland\u0131.(61) Cutting balon 3 veya 4 uzunlamas\u0131na b\u0131\u00e7ak ihtiva eder. 0,25 mm y\u00fckseklikte ve 0,08 mm derinlikte olup balon \u015fi\u015firildi\u011finde katlanm\u0131\u015f halde duran b\u0131\u00e7aklar dik konuma ge\u00e7erek aterosklerotik pla\u011f\u0131 keser ve yar\u0131k olu\u015fturur. Balon bu yar\u0131klar\u0131 art\u0131rarak geni\u015f bir l\u00fcmen elde edilmesini sa\u011flar . (T\u00fcrkiyede ilk Cutting balon, 1995\u2019te Prof.Dr. Ferhan \u00d6ZMEN taraf\u0131ndan)<\/p>

\"\"<\/a>1991 :<\/strong> T\u00fcrkiyede ilk stent uygulamas\u0131 Do\u00e7.Dr.Tu\u011frul Okay taraf\u0131ndan yap\u0131ld\u0131. (70)<\/p>

\u00a0<\/strong><\/p>

1992 :<\/strong> Stent’e ilk FDA onay\u0131, balon sonras\u0131 ani t\u0131kanan damara tedavi amac\u0131 ile verildi.<\/p>

1993 :<\/strong> FDA akut koroner t\u0131kanmalarda Gianturca Roubin stentlerine onay verdi. (70)<\/p>

1993 :<\/strong> Morice ve ark. (Fransa), stentlerin, aspirin heparin ve warfarinin beraber kullan\u0131lmalar\u0131na ra\u011fmen yeterince \u00f6nlenemeyen erken d\u00f6nem t\u0131kanmalar\u0131na ( subakut tromboza ) kar\u015f\u0131 yeni bir tedavi protokolu (Ticlopidin+aspirin ile) yay\u0131nlad\u0131. (62)<\/p>

\"\"<\/a>1994 :<\/strong> Antonio Colombo stent trombozunun (p\u0131ht\u0131la\u015fmayla t\u0131kanmas\u0131n\u0131n) \u00f6nlenebilmesi i\u00e7in stent a\u00e7\u0131lmas\u0131n\u0131n m\u00fckemmelle\u015ftirilmesi gereklili\u011fine ve y\u00fcksek bas\u0131n\u00e7 uygulamas\u0131na dikkat \u00e7ekti ve stent kullan\u0131m\u0131n\u0131n da yeni bir \u00e7\u0131\u011f\u0131r a\u00e7\u0131ld\u0131. (63)<\/p>

2001 :<\/strong> Stent sonras\u0131 tekrar daralma ve t\u0131kanmalar\u0131 engelleyebilmek amac\u0131yla, bir m\u00fcddettir \u00e7al\u0131\u015fmalar\u0131 yap\u0131lan \u201cila\u00e7 kapl\u0131 stentler\u201d ile ilgili ilk sonu\u00e7lar yay\u0131nland\u0131. Sausa ve arkada\u015flar\u0131 \u201cSirolismus\u201d salan stentlerle yapt\u0131klar\u0131 30 vakal\u0131k serinin sonu\u00e7lar\u0131n\u0131 yay\u0131nlad\u0131lar. (64),(70)<\/p>

KALP CERRAH\u0130S\u0130’NDE K\u0130LOMETRE TA\u015eLARI (69)<\/h2>

\"\"<\/a>1828 :<\/strong> James Blandell ilk ba\u015far\u0131l\u0131 kan transf\u00fczyonunu yapt\u0131. Bu daha sonraki y\u0131llarda yap\u0131lacak olan kardiak giri\u015fimlerin emin bir bi\u00e7imde yap\u0131labilmesine imkan sa\u011flayan \u00f6nemli bir geli\u015fmedir.<\/p>

\u00a0<\/p>

\"\"<\/a>1891 :<\/strong> Bir b\u0131\u00e7ak yaralanmas\u0131 vakas\u0131nda, Amerikal\u0131 cerrah Henry Dalton<\/a> taraf\u0131ndan kalbin etraf\u0131n\u0131 \u00e7evreleyen zarlar (perikart), diki\u015f at\u0131larak ilk kez tamir edildi.(65) Hekimli\u011fin tarih i\u00e7erisindeki geli\u015fiminde kalp, her zaman korkulan ve \u00f6zellikle cerrahi a\u00e7\u0131dan uzak durulmas\u0131 gereken bir organ olarak alg\u0131lanm\u0131\u015ft\u0131r. Kalp cerrahisinin geli\u015fimi konusunda Prof.Sherman\u2019\u0131n s\u00f6yledi\u011fi gibi; “Kalbe olan mesafe sadece birka\u00e7 santimetre oldu\u011fu halde cerrahi bu yolu ancak 2400 y\u0131lda katedebilmi\u015ftir.(66) \u0130\u015fte, Henry Dalton\u2019un bu ilk operasyonu, bu yolun hedefe ula\u015ft\u0131\u011f\u0131 nokta ve kalp cerrahisinin ba\u015flang\u0131c\u0131 say\u0131labilir.<\/p>

\"\"<\/a>1893 :<\/strong> Dr. Daniel Hale Williams<\/a>, a\u00e7\u0131k kalp cerrahisi ile perikart tamiri yapan ikinci cerrah olarak kay\u0131tlara ge\u00e7mi\u015ftir. (65)<\/p>

\u00a0<\/p>

\"\"<\/a>1896 :<\/strong> Kesici aletle kalbinden yaralanan bir asker, Alman cerrah Dr. Ludwig Rehn<\/a> taraf\u0131ndan ba\u015far\u0131yla ameliyat edilerek, sa\u011f ventrik\u00fcl adalesindeki 1.5 cm\u2019lik kesi 3 diki\u015fle tamir edildi. Dr. Rehn, bir kalp yaralanmas\u0131nda kalp kas\u0131n\u0131 dikerek hastay\u0131 ya\u015fatan ilk cerrah olmu\u015ftur.(65) Bu bir\u00e7ok yazarca ilk ba\u015far\u0131l\u0131 kalp operasyonunu olarak kabul edilmektedir. Bu operasyonlarla kalp yaralar\u0131n\u0131n iyile\u015ftirilemeyece\u011fi yarg\u0131s\u0131 sona ermi\u015ftir.<\/p>

\"\"<\/a>1900 :<\/strong> Karl Landsteiner<\/a>\u2019\u0131n kan gruplar\u0131n\u0131 bulmas\u0131yla, kalp cerrahisinde \u00f6nemli bir engel olan transf\u00fczyon reaksiyonlar\u0131 sorunu a\u015f\u0131lm\u0131\u015f oldu.<\/p>

1905 :<\/strong> Alexis Carrel<\/a> ve C. Guthrie 1905\u2019de University of Chicago\u2019da kalp ve akci\u011fer nakilleri bildirmi\u015flerdir. K\u00f6pek \u00fczerinde yap\u0131lan bu giri\u015fim, p\u0131ht\u0131 engelleyici tedavi kullan\u0131lmad\u0131\u011f\u0131 i\u00e7in iki saat i\u00e7inde kalp bo\u015fluklar\u0131nda geli\u015fen tromb\u00fcs (p\u0131ht\u0131) ile sonlanm\u0131\u015ft\u0131r.<\/p>

\"\"<\/a>1910 :<\/strong> Koroner Arter Cerrahisinde ilk ad\u0131m olarak Alexis Carrel inen aort ile sol koroner arter aras\u0131nda bir indirekt anastomoz (damar\u0131 damara dikme i\u015flemi) fikri ile giri\u015fimde bulunmu\u015f ancak hareketli kalpte, anastomozun \u00e7ok k\u0131sa s\u00fcrede bitirilmesi gerekti\u011finden teknik olarak \u00e7ok zor oldu\u011funu bildirmi\u015ftir. O tarihten sonra 1930\u2019a kadar koroner arter cerrahisi alan\u0131nda pek giri\u015fim olmam\u0131\u015ft\u0131r.<\/p>

\"\"<\/a>1915 :<\/strong> Kalp cerrahisinin temel ihtiya\u00e7lar\u0131ndan birisi de, cerrahi prosed\u00fcr s\u0131ras\u0131nda p\u0131ht\u0131la\u015fman\u0131n engellenmesidir (antikoag\u00fclasyon). Heparin 1915\u2019te bir t\u0131p \u00f6\u011frencisi; Jay McLean<\/a> taraf\u0131ndan bulunmu\u015ftur. Sonu\u00e7lar 1916\u2019da bildirilmi\u015f, 1920\u2019deki deneyler heparinin etkili bir antikoag\u00fclan oldu\u011funu g\u00f6stermi\u015ftir.<\/p>

\"\"<\/a>1912 :<\/strong> Stenotik (daralm\u0131\u015f) bir kapa\u011f\u0131 a\u00e7maya y\u00f6nelik ilk giri\u015fim Theodore Tuffier<\/a> taraf\u0131ndan ger\u00e7ekle\u015ftirildi. Tuffier asendan aorta duvar\u0131n\u0131 d\u0131\u015far\u0131dan parmak yard\u0131m\u0131 ile stenotik aort kapa\u011f\u0131na ilerletmi\u015f ve stenotik kapa\u011f\u0131 geni\u015fletmeyi ba\u015farm\u0131\u015ft\u0131r.<\/p>

1923 :<\/strong> Eliott Cutler, ilk kez valvulatom ad\u0131n\u0131 verdi\u011fi \u00f6zel bir b\u0131\u00e7ak yard\u0131m\u0131yla 12 ya\u015f\u0131nda bir k\u0131z hastaya mitral valvulotomi (daralm\u0131\u015f ve a\u00e7\u0131l\u0131m\u0131 iyice k\u0131s\u0131tlanm\u0131\u015f bir kalp kapa\u011f\u0131n\u0131, \u00f6zel bir b\u0131\u00e7ak yard\u0131m\u0131 ile kesip, daha fazla a\u00e7\u0131lmas\u0131n\u0131 sa\u011flama i\u015flemi) uygulad\u0131.<\/p>

\"\"<\/a>1924 :<\/strong> \u0130lk pulmoner embolektomi, Frederic Trendelenburg taraf\u0131ndan1908 y\u0131l\u0131nda denenmi\u015f ve yay\u0131nlanm\u0131\u015f, \u00f6\u011frencisi Kirshner taraf\u0131ndan ise 1924 y\u0131l\u0131nda ba\u015far\u0131lm\u0131\u015ft\u0131r.<\/p>

\u00a0<\/p>

\"\"<\/a>1931 :<\/strong> Kalp-Akci\u011fer makinesi kullan\u0131m\u0131 ile ilgili ilk d\u00fc\u015f\u00fcnce masif pulmoner embolili bir hastan\u0131n ba\u015f\u0131nda ortaya \u00e7\u0131kt\u0131. Kan\u0131n toplar damardan al\u0131n\u0131p oksijenlenebilece\u011fi bir cihazda toplanmas\u0131 ve daha sonra bir pompa vas\u0131tas\u0131yla tekrar atar damardan dola\u015f\u0131ma kat\u0131lmas\u0131 fikri kalp-akci\u011fer makinesinin temeli olarak d\u00fc\u015f\u00fcn\u00fclm\u00fc\u015ft\u00fcr. Bu d\u00fc\u015f\u00fcnceleri ortaya atan John Gibbon\u2019\u0131n \u00e7al\u0131\u015fmalar\u0131 bunu takip eden 20 sene boyunca Massachusetts General Hospital\u2019da devam etmi\u015ftir.<\/p>

1937 :<\/strong> Gibbon ilk kez ya\u015fam\u0131n suni bir kalp ve akci\u011fer ile devam ettirilebildi\u011fini bildirdi.<\/p>

\"\"<\/a>1938 :<\/strong> Aort ile Pulmoner arter aras\u0131nda var olan ge\u00e7i\u015fin do\u011fum sonras\u0131 kapanmamas\u0131 olarak tarif edebilece\u011fimiz Patent Ductus Arteriozus\u2019un kapat\u0131lmas\u0131 ameliyat\u0131, Robert Gross taraf\u0131ndan ba\u015far\u0131ld\u0131. Bu tarih, kalp cerrahisinin konjenital kalp hastal\u0131klar\u0131n\u0131n tedavisine kap\u0131lar\u0131n\u0131 a\u00e7t\u0131\u011f\u0131 g\u00fcn olarak kabul edilir.<\/p>

\"\"<\/a>1946 :<\/strong> Koroner arter cerrahisinde Alexis Carrel\u2019in 1910\u2019daki \u00e7abalar\u0131ndan sonra ikinci \u00f6nemli giri\u015fim olarak, A. Vineberg\u2019in internal mamarian arteri myokard i\u00e7indeki bir t\u00fcnele g\u00f6mme tekni\u011fini geli\u015ftirmesi say\u0131labilir. 1960\u2019larda Birle\u015fik Devletler ve Kanada\u2019da bir\u00e7ok merkezde bu giri\u015fim uygulanm\u0131\u015ft\u0131r.(71)<\/p>

\"\"<\/a><\/p>

1947 :<\/strong> \u0130lk ba\u015far\u0131l\u0131 pulmoner valvulotomi Thomas Holmes Sellers taraf\u0131ndan Fallot tetralojisi olan bir \u00e7ocuk \u00fczerinde ger\u00e7ekle\u015ftirildi.<\/p>

\u00a0<\/p>

\"\"<\/a>1951 :<\/strong> Clarence Dennis ilk kez 1951\u2019de kalp-akci\u011fer makinesini klinikte kulland\u0131. Hasta ba\u015fka nedenlerle kaybedilmi\u015f olsa da bu deneyimde kalp-akci\u011fer makinesinin iyi \u00e7al\u0131\u015ft\u0131\u011f\u0131 g\u00f6r\u00fcld\u00fc. Ayn\u0131 y\u0131l, Forrest Dodrill ise mekanik pompas\u0131n\u0131, 1952\u2019de sol bypass i\u00e7in kullanm\u0131\u015f ve 50 dakika s\u00fcre ile sol ventrik\u00fcl\u00fc devre d\u0131\u015f\u0131 b\u0131rak\u0131p mitral kapak cerrahisi uygulam\u0131\u015ft\u0131r. Bu ilk ba\u015far\u0131l\u0131 sol kalp by-pass\u0131d\u0131r. Daha sonra Dodrill makineyi 16 ya\u015f\u0131nda pulmoner stenozlu bir \u00e7ocukta kullanm\u0131\u015f ve ilk ba\u015far\u0131l\u0131 sa\u011f kalp bypass\u0131n\u0131 ger\u00e7ekle\u015ftirmi\u015ftir.<\/p>

\"\"<\/a>1952 :<\/strong> Vladimir Demikhov k\u00f6peklerde internal mamarian arter ile sol koroner arter anastomozu \u00fczerinde \u00e7al\u0131\u015ft\u0131.(71)<\/p>

\u00a0<\/p>

\"\"<\/a>1953 :<\/strong> Ekstrakorporeal dola\u015f\u0131m (Kalp-Akci\u011fer mekinesi) tekni\u011fini kullanarak d\u00fcnyada ilk ba\u015far\u0131l\u0131 a\u00e7\u0131k kalp ameliyat\u0131n\u0131 John Gibbon yapm\u0131\u015ft\u0131r. Gibbon 1953\u2019te 18 ya\u015f\u0131ndaki bir hastada bu tekni\u011fi kullanarak atrial septum defektini ba\u015far\u0131yla kapatm\u0131\u015ft\u0131r. 22 y\u0131l s\u00fcren bir ara\u015ft\u0131rman\u0131n \u00fcr\u00fcn\u00fc olan bu yeni uygulama kalp cerrahisinde \u00e7\u0131\u011f\u0131r a\u00e7m\u0131\u015ft\u0131r.<\/p>

1954 : T\u00fcrkiye\u2019de modern kalp cerrahisinin ilk ad\u0131mlar\u0131 kapal\u0131 mitral komiss\u00fcrotomi ile ba\u015flad\u0131. 1953 ve 1954 y\u0131llar\u0131nda \u0130stanbul\u2019da Dr. Nihat Dorken ve Dr. Fahri Arel, Ankara\u2019da Dr. Orhan Mumin ve Dr. Hilmi Ak\u0131n bunun \u00f6nc\u00fcl\u00fc\u011f\u00fcn\u00fc yapt\u0131lar.<\/p>

\"\"<\/a>1955 :<\/strong> Mayo Clinic\u2019de JW Kirklin<\/a> a\u00e7\u0131k kalp program\u0131n\u0131 ba\u015flatt\u0131. Gibbon-IBM makinesi \u00fczerine geli\u015ftirdikleri bir kalp-akci\u011fer makinesi kullanm\u0131\u015flard\u0131r. Bu teknikle \u00fcst \u00fcste ba\u015far\u0131l\u0131 sonu\u00e7lar elde etmi\u015ftir. O tarihte Kirklin ve Lillehei<\/a> d\u00fcnyada kalp-akci\u011fer makinesi kullanarak a\u00e7\u0131k kalp ameliyat\u0131 ger\u00e7ekle\u015ftiren cerrahlar olmu\u015flard\u0131r. 1956 y\u0131l\u0131n\u0131n sonunda art\u0131k pek \u00e7ok grup a\u00e7\u0131k kalp programlar\u0131n\u0131 ba\u015flatm\u0131\u015flard\u0131. G\u00fcn\u00fcm\u00fczde kalp-akci\u011fer makinesi kullan\u0131larak y\u0131lda 500 binin \u00fczerinde a\u00e7\u0131k kalp ameliyat\u0131 ger\u00e7ekle\u015ftirilmektedir.(71)<\/p>

1956 :<\/strong> C Walton Lillehei kardiyopulmoner by-pass kullanarak ilk a\u00e7\u0131k mitral komissurotomiyi ger\u00e7ekle\u015ftirdi.<\/p>

1959 :<\/strong> Sones, kendi koroner damarlar\u0131n\u0131 g\u00f6stererek, ilk selektif koroner anjiyografiyi yapt\u0131. Bu olay, modern vask\u00fcler tekniklerinin geli\u015fmesine ve giri\u015fimsel kardiyolojinin do\u011fmas\u0131na neden olmu\u015ftur. (30,31) Ayn\u0131 zamanda a\u00e7\u0131k kalp cerrahisinin geli\u015fiminin de kilometre ta\u015f\u0131d\u0131r.<\/p>

\"\"<\/a>1960 :<\/strong> Kalp kapa\u011f\u0131 tamirleri ve replasmanlar\u0131 kardiyopulmoner bypass\u0131n yayg\u0131n kullan\u0131m\u0131 ile b\u00fcy\u00fck ilerleme kaydetmi\u015ftir. ilk kez 1960\u2019da aort kapak replasman\u0131n\u0131 (bozulmu\u015f apa\u011f\u0131n yapay bir kapakla de\u011fi\u015ftirilmesi operasyonunu) ger\u00e7ekle\u015ftirmi\u015f, toplu-kafesli bir kapak kullanm\u0131\u015ft\u0131r. Starr ve Edwards ise mitral kapa\u011f\u0131 kendi geli\u015ftirdikleri bir toplu-kafesli protez ile de\u011fi\u015ftirmi\u015ftir.<\/p>

\"\"<\/a>1960 :<\/strong> \u00dclkemizde ekstrakorporeal dola\u015f\u0131m kullanmak suretiyle ilk a\u00e7\u0131k kalp ameliyat\u0131 te\u015febb\u00fcs\u00fc 1960 y\u0131l\u0131nda Dr. Mehmet Tekdo\u011fan taraf\u0131ndan Hacettepe \u00dcniv. Hastanesi\u2019nde ger\u00e7ekle\u015ftirilmi\u015ftir. Seri halindeki a\u00e7\u0131k kalp ameliyatlar\u0131nda ise Dr. Ayd\u0131n Ayta\u00e7 taraf\u0131ndan 1962 y\u0131l\u0131nda Hacettepe T\u0131p Fak\u00fcltesi\u2019nde ba\u015fland\u0131.<\/p>

\"\"<\/a>1963 :<\/strong> Dr. Siyami Ersek ve arkada\u015flar\u0131 Haydarpa\u015fa\u2019da seri halinde a\u00e7\u0131k kalp ameliyat\u0131 uygulad\u0131lar ve T\u00fcrkiye\u2019de ilk defa yapay kapak takt\u0131lar.<\/p>

1964 :<\/strong> W Dudley Johnson 1962\u2019den itibaren koroner cerrahide revask\u00fclarizasyon ( yeniden damarland\u0131rma ) tekniklerini kullanarak birka\u00e7 nadir vaka bildirmi\u015f ancak bunlar koroner arter cerrahisinin geli\u015fimine pek katk\u0131da bulunmam\u0131\u015ft\u0131r. W.D.Johnsan, 1964\u2019de 42 ya\u015f\u0131nda koroner endarterektomi yap\u0131lan bir hastaya zorunluluktan dolay\u0131 safen ven ile bypass yapt\u0131. Johnson\u2019\u0131n yapt\u0131\u011f\u0131 bu anastomoz, ilk ba\u015far\u0131l\u0131 koroner bypass say\u0131l\u0131r.<\/p>

\"\"<\/a>1967 :<\/strong> \u0130nsandan insana ilk kalp nakli Aral\u0131k 1967\u2019de G\u00fcney Afrika\u2019da Capetown\u2019da ger\u00e7ekle\u015ftirilmi\u015ftir. Cerrahi tak\u0131m\u0131n liderli\u011fini Christian Barnard<\/a> \u00fcstlenmi\u015ftir. Barnard\u2019\u0131n hastas\u0131 postoperatif onsekizinci g\u00fcnde kaybedilmi\u015ftir. \u00d6l\u00fcm nedeni imm\u00fcnsupresyona ba\u011fl\u0131 geli\u015fen pn\u00f6moni olarak g\u00f6r\u00fclm\u00fc\u015ft\u00fcr. Barnard\u2019\u0131n ikinci hastas\u0131 ilk hastas\u0131n\u0131n \u00f6l\u00fcm\u00fcnden 12 g\u00fcn sonra ameliyat edilmi\u015f, iki y\u0131ldan fazla ya\u015fayan transplant hastas\u0131 Barnard\u2019\u0131 b\u00fcy\u00fck bir \u00fcne kavu\u015fturmu\u015ftur. Ayn\u0131 y\u0131l Amerika\u2019da Shumway, Lillehei, Cooley ve Avrupa\u2019da Duboist ilk vakalar\u0131n\u0131 yapt\u0131lar. \u0130lk kalp naklini takip eden sene i\u00e7erisinde de\u011fi\u015fik merkezlerde 99 kalp transplantasyonu ger\u00e7ekle\u015ftirilmi\u015f ancak y\u00fcksek rejeksiyona (redde) ba\u011fl\u0131 \u00f6l\u00fcmler nedeniyle \u00e7o\u011fu merkezde b\u0131rak\u0131lm\u0131\u015ft\u0131r. Daha iyi imm\u00fcnsupresif (ba\u011f\u0131\u015f\u0131kl\u0131k sistemini bask\u0131lay\u0131c\u0131) ila\u00e7lar\u0131n ke\u015ffi i\u00e7in harcanan \u00e7aba sonucunda kalp transplantasyonunda bug\u00fcnk\u00fc noktaya gelinmi\u015ftir. 1981\u2019de Stanford University\u2019de Reitz\u2019in siklosporin A\u2019y\u0131 kullanmas\u0131yla kalp-akci\u011fer nakilleri tekrar h\u0131z kazanm\u0131\u015ft\u0131r. \u0130lk akci\u011fer transplantsayonu 1964\u2019de University of Mississippi\u2019de Hardy taraf\u0131ndan ger\u00e7ekle\u015ftirilmi\u015ftir. Ancak akci\u011fer transplantasyonunda b\u00fcy\u00fck ba\u015far\u0131 Joel Cooper\u2019\u0131n Toronto grubuna aittir.<\/p>

\"\"<\/a>1967 :<\/strong> Bir ba\u015fka Rus cerrah Kolessov angina pektorisin tedavisinde mamarian arter-koroner arter anastomozlar\u0131n\u0131 bildirdi.<\/p>

1968 :<\/strong> \u0130lk insandan insana kalp nakli amileyat\u0131n\u0131n Dr. Barnard taraf\u0131ndan ger\u00e7ekle\u015ftirilmesinden sonra onu takip eden y\u0131l i\u00e7inde Dr. Bayezid Ankara\u2019da Y\u00fcksek \u0130htisas Hast.\u2019de ve 2 g\u00fcn sonra Dr. Ersek \u0130stanbul G\u00f6\u011f\u00fcs Cerrahisi Merkezinde teknik y\u00f6nden ba\u015far\u0131l\u0131 2 kalp nakli yapt\u0131lar.<\/p>

1968 :<\/strong> Green, Bailey ve Hirose ayr\u0131 ayr\u0131 mamarian arter koroner arter anastomozlar\u0131n\u0131 bildirdiler. Bailey ve Hirose anastomozlar\u0131 \u00e7arpan kalpte tamamlarken Green kardiyopulmoner bypass y\u00f6ntemiyle kalbin durdurulup kandan ar\u0131nd\u0131ktan sonra anastomozlar\u0131n yap\u0131lmas\u0131n\u0131 savunmu\u015ftur. Cleveland Clinic\u2019den Rene Favalaro koroner bypasslarda safen veni kullanm\u0131\u015f ve bu seriyi 1968\u2019de yay\u0131nlam\u0131\u015ft\u0131r.<\/p>

1969 :<\/strong> Favalaro, Kolessov, Green, Bailey ve Hirose\u2019nin \u00f6nemli katk\u0131lar\u0131n\u0131n yan\u0131nda, bug\u00fcn bildi\u011fimiz anlamda koroner arter cerrahisinin resmi ba\u015flang\u0131c\u0131 1969\u2019da W Dudley Johnson\u2019\u0131n bildirdi\u011fi seri ile olmu\u015ftur.<\/p>

1974 :<\/strong> \u00dclkemizdeki ilk koroner by-pass ameliyat\u0131 \u015eubat 1974\u2019te Dr. Ayta\u00e7 taraf\u0131ndan safen ven kullan\u0131lmak suretiyle bir bayan hastada ba\u015far\u0131yla uyguland\u0131. (67) T\u00fcrkiye\u2019de seri halinde ve bol say\u0131da koroner by-pass ameliyatlar\u0131n\u0131 yerle\u015ftirmek ise Y\u00fcksek \u0130htisas Hastanesi\u2019nde Dr. Beyaz\u0131t ve ark. taraf\u0131ndan ger\u00e7ekle\u015ftirildi.(68)<\/p>

\"\"<\/a>1989 :<\/strong> Dr. Cevat Yakut\u2019un ba\u015fkanl\u0131\u011f\u0131nda bilhassa eri\u015fkin kalp cerrahisinde b\u00fcy\u00fck seriler halinde ba\u015far\u0131l\u0131 ameliyatlar uygulanan Ko\u015fuyolu Hast.\u2019de T\u00fcrkiye\u2019de ilk olarak ameliyattan sonra uzun s\u00fcre ya\u015fayan kalp nakli, aradan \u00e7ok uzun y\u0131llar ge\u00e7tikten sonra Dr. Yakut ve Dr. \u00d6mer Beyaz\u0131t taraf\u0131ndan 1989\u2019da yap\u0131ld\u0131. Bunu Hacettepe Hast.\u2019de Dr. \u0130lhan Pa\u015fao\u011flu taraf\u0131ndan yap\u0131lan fakat akut rejeksiyonla erken d\u00f6nemde kaybedilen olgu izledi. Daha sonra yine Hacettepe\u2019de Dr. Bozer ve Dr. Pa\u015fao\u011flu taraf\u0131ndan 5 kalp nakli ameliyat\u0131 daha yap\u0131ld\u0131.<\/p>

\"\"<\/a>1998 :<\/strong> T\u00fcrkiye\u2019de ilk kez Kalp ve Akci\u011fer transplantasyonu, 9 Eyl\u00fcl \u00dcniversitesi\u2019nde Prof.Dr.\u00d6ztekin Oto ve ekibi taraf\u0131ndan yap\u0131ld\u0131.,<\/p>

1999 :<\/strong> \u00dclkemizde iki tarafl\u0131 akci\u011fer transplantasyonu yine ayn\u0131 \u00fcniversitede Dr. Oto ve ekibi taraf\u0131ndan ger\u00e7ekle\u015ftirilmi\u015ftir.<\/p>

\u00a0<\/h2>

KAYNAK\u00c7A<\/h2>

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<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

Kardiyoloji’de bug\u00fcn kullan\u0131lan tekniklerin tarihsel s\u00fcreci ve kilometre ta\u015flar\u0131<\/p>\n","protected":false},"author":1,"featured_media":8147,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[36],"tags":[128,125,133,114,129,123,127,126,130,118,116,120,119,122,113,132,115,124,117,131,112,121,111],"class_list":["post-8144","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-kalp-sagligi","tag-alexis-carrel","tag-antonio-colombo","tag-cevat-yakut","tag-charles-dotter","tag-frederic-trendelenburg","tag-gruentzig","tag-henry-dalton","tag-james-blandell","tag-john-gibbon","tag-judkins","tag-mason-sones","tag-mehmet-ozdemir","tag-melvin-paul-judkins","tag-oral-pektas","tag-robb-ve-steinberg","tag-siyami-ersek","tag-sven-seldinger","tag-tugrul-okay","tag-turhan-akyol","tag-vladimir-demikhov","tag-werner-forsmann","tag-werner-porstmann","tag-wilhelm-konrad-roentgen"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/drhasankasap.com\/index.php\/wp-json\/wp\/v2\/posts\/8144","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drhasankasap.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drhasankasap.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drhasankasap.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/drhasankasap.com\/index.php\/wp-json\/wp\/v2\/comments?post=8144"}],"version-history":[{"count":48,"href":"https:\/\/drhasankasap.com\/index.php\/wp-json\/wp\/v2\/posts\/8144\/revisions"}],"predecessor-version":[{"id":8962,"href":"https:\/\/drhasankasap.com\/index.php\/wp-json\/wp\/v2\/posts\/8144\/revisions\/8962"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drhasankasap.com\/index.php\/wp-json\/wp\/v2\/media\/8147"}],"wp:attachment":[{"href":"https:\/\/drhasankasap.com\/index.php\/wp-json\/wp\/v2\/media?parent=8144"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drhasankasap.com\/index.php\/wp-json\/wp\/v2\/categories?post=8144"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drhasankasap.com\/index.php\/wp-json\/wp\/v2\/tags?post=8144"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}