Papers by Gonzalo Urcelay
Revista chilena de pediatría, Dec 1, 1987
Fecal alpha-1-antitrypsin in infants. Reference values and in acute diarrhoeal disease Alpha-l-an... more Fecal alpha-1-antitrypsin in infants. Reference values and in acute diarrhoeal disease Alpha-l-antitrypsin (a-l-AT) was determined in faeces by agorose radial inmunodiffusion plates in order to establish reference values in random faecal samples, and to determine the magnitude of intestinal protein loss in acute diarrhoea and its eventual association with the aetiology and clinical progress of the disturbance. Fifty three patients 1 to 11 months of age were studied. Fifteen infants admitted with acute respiratory disease, were investigated when fully recovered, just before discharge: reference values found were (mg/g dry weight): 4.80 to 50.80 (x ± 2 SD n _i)-Thirty eight cases with acute diarrhoea were studied within 24 hours after admission: increased faecal a-l-AT loss was detected in 47.3% of these patients, with 3 cases showing loses greater than 100 mg/g. Severe malnutrition was not observed. Faecal. a-l-AT loss was neither related to nutritional status nor to the aetiology of diarrhoea. However, increased loss was associated to watery stools, prolonged hcapitalization and probably to protracted diarrhoea (p-0.05).
Revista chilena de pediatría, 2018
Introduction: Tetralogy of Fallot (TOF) is the most frequent cyanotic congenital heart disease. P... more Introduction: Tetralogy of Fallot (TOF) is the most frequent cyanotic congenital heart disease. Pulmonary regurgitation (PR) and right ventricle (RV) enlargement and dysfunction are the most common long-term complications. Cardiac magnetic resonance (CMR) is the gold standard for RV evaluation. Objective: To analyze CMR results in the follow-up of TOF patients. Patients and Method: All CMR performed between 2007 and 2012 in TOF patients with transannular patch (TAP) repair or infundibular widening, and without pulmonary valve replacement (PVR) were included. Pulmonary regurgitant fraction (PRF), ventricular end-diastolic (EDV) and end-systolic volume (ESV), and ejection fraction (EF) were examined. Results: 122 CMR were performed in 114 patients. Average age at CMR was 15.4±7.4 years. 53.3% of them presented severe PR (> 40%). RVEDV was 157.3 ± 38.6 ml/m 2 , RVESV was 85.3 ± 27 ml/m 2 and RVEF was 46.4 ± 7.1%. RVEDV was > 150 ml/ m 2 in 48.4% and > 170 ml/m 2 in 32.8% of patients. Patients with TAP showed larger RV volumes compared with those with infundibular widening. RVEDV > 170 ml/m 2 showed worse RVEF that those with lower RVEDV (47.9 ± 7% vs 43.2 ± 6.4%, p < 0.01). Conclusion: Almost half of the patients showed significant RV enlargement, demonstrating that the indication of CMR is late in their follow-up. TAP was associated with higher RVEDV and RVESV, but no worse RVEF.
Revista Medica De Chile, Sep 1, 2006
Cardiac tumors in children and adults: A retrospective study Background: Cardiac tumors are very ... more Cardiac tumors in children and adults: A retrospective study Background: Cardiac tumors are very uncommon at all ages. There are important clinical differences between children and adults in the behavior of these tumors. Aim: To compare the behavior of primary and secondary cardiac tumors, from fetal age to adults. Patients and Method: Multicentric retrospective analysis of 38 children and adults with cardiac tumors, evaluated with echocardiography between January 1995 and August 2001. Medical records, echocardiographic and radiological examinations, surgical protocols and pathologic examinations were reviewed. Follow-up was obtained through data on medical records or calling patients by telephone. Results: Tumors were diagnosed in 38 patients (13 children and 25 adults), from a total of 31.800 echocardiograms. In children the diagnosis was made by fetal, transthoracic or transesophageal echocardiography in 23.6% and 8% of cases, respectively. Eighty five percent were primary (10 benign and 1 malignant) and 15%, secondary tumors. Fifty four percent were rhabdomyomas and 75% regressed spontaneously. Seventy seven percent were symptomatic and 31% were treated with surgery. During a follow up of 44±35 months, 31% of patients died. In adults, 76% of tumors were diagnosed by transthoracic and 20% by transesophageal echocardiography. Seventy six percent were primary (18 benign and 1 malignant) and 24% secondary tumors. Fifty six percent were myxomas. Ninety two percent were symptomatic and 84% were treated surgically. Twenty percent of patients died in the early postoperative period. No adult patients had a follow-up. Conclusions: Rhabdomyomas were solely found in children. In adults, myxomas are the predominat cardiac tumors. Primary and metastasic malignant tumors are observed both in children and in adults (Rev Méd Chile 2006; 134: 1135-45).
American Journal of Physiology-heart and Circulatory Physiology, May 1, 2001
Hypoplastic left heart syndrome is the most common lethal cardiac malformation of the newborn. It... more Hypoplastic left heart syndrome is the most common lethal cardiac malformation of the newborn. Its treatment, apart from heart transplantation, is the Norwood operation. The initial procedure for this staged repair consists of reconstructing a circulation where a single outlet from the heart provides systemic perfusion and an interpositioning shunt contributes blood flow to the lungs. To better understand this unique physiology, a computational model of the Norwood circulation was constructed on the basis of compartmental analysis. Influences of shunt diameter, systemic and pulmonary vascular resistance, and heart rate on the cardiovascular dynamics and oxygenation were studied. Simulations showed that 1) larger shunts diverted an increased proportion of cardiac output to the lungs, away from systemic perfusion, resulting in poorer O2 delivery, 2) systemic vascular resistance exerted more effect on hemodynamics than pulmonary vascular resistance, 3) systemic arterial oxygenation was minimally influenced by heart rate changes, 4) there was a better correlation between venous O 2 saturation and O 2 delivery than between arterial O2 saturation and O2 delivery, and 5) a pulmonary-to-systemic blood flow ratio of 1 resulted in optimal O 2 delivery in all physiological states and shunt sizes. congenital heart disease; computer model; hypoplastic left heart syndrome HYPOPLASTIC LEFT HEART SYNDROME is a lethal condition characterized by a hypoplasia of the left ventricle, the mitral valve, the aortic valve, and the ascending aorta. Preoperative survival relies on the patency of the ductus arteriosus to supply the systemic circulation.
Revista chilena de pediatría, 1996
Revista chilena de radiología, 2003
Abstract : Nowadays the magnetic resonance images has gained every day more importance in the dia... more Abstract : Nowadays the magnetic resonance images has gained every day more importance in the diagnosis and following of congenital heart disease. It gives anatomic, and more recently functional information. We present our experience from January to August of 2002, in five ...
Revista chilena de pediatría, 2005
... Pedro Becker R. 1 , Patricia Frangini S. 2 , Claudio Arretz V. 1 , Felipe Heusser R. 2 , Gonz... more ... Pedro Becker R. 1 , Patricia Frangini S. 2 , Claudio Arretz V. 1 , Felipe Heusser R. 2 , Gonzalo Urcelay M. 2 , Ricardo Zalaquett S. 1 , Manuel José Irarrázaval L. 1 , Sergio Morán V. 1 , Pilar Arnaiz G. 2 , Francisco Garay G. 2 , Cristián Clavería ... Links ] 13.- Caldarone C, Raghuveer ...
Revista médica de Chile, 2005
Interstitial lung diseases are uncommon in children, and can be idiopathic or secondary to known ... more Interstitial lung diseases are uncommon in children, and can be idiopathic or secondary to known causes, sharing common pathological findings. We report a girl with progressive respiratory insufficiency secondary to interstitial pneumonia and pulmonary fibrosis, with risk factors such as bronchopulmonary dysplasia and respiratory infections (respiratory syncytial virus and suspected Mycoplasma pneumoniae), that may have had an additive effect. Nasal bi-level Positive Airway Pressure was used in the last period of her disease. She died due to global respiratory failure at the age of 14 years (Rev Méd Chile 2005; 133; 82-88).
Revista médica de Chile, 2006
Cardiac tumors in children and adults: A retrospective study Background: Cardiac tumors are very ... more Cardiac tumors in children and adults: A retrospective study Background: Cardiac tumors are very uncommon at all ages. There are important clinical differences between children and adults in the behavior of these tumors. Aim: To compare the behavior of primary and secondary cardiac tumors, from fetal age to adults. Patients and Method: Multicentric retrospective analysis of 38 children and adults with cardiac tumors, evaluated with echocardiography between January 1995 and August 2001. Medical records, echocardiographic and radiological examinations, surgical protocols and pathologic examinations were reviewed. Follow-up was obtained through data on medical records or calling patients by telephone. Results: Tumors were diagnosed in 38 patients (13 children and 25 adults), from a total of 31.800 echocardiograms. In children the diagnosis was made by fetal, transthoracic or transesophageal echocardiography in 23.6% and 8% of cases, respectively. Eighty five percent were primary (10 benign and 1 malignant) and 15%, secondary tumors. Fifty four percent were rhabdomyomas and 75% regressed spontaneously. Seventy seven percent were symptomatic and 31% were treated with surgery. During a follow up of 44±35 months, 31% of patients died. In adults, 76% of tumors were diagnosed by transthoracic and 20% by transesophageal echocardiography. Seventy six percent were primary (18 benign and 1 malignant) and 24% secondary tumors. Fifty six percent were myxomas. Ninety two percent were symptomatic and 84% were treated surgically. Twenty percent of patients died in the early postoperative period. No adult patients had a follow-up. Conclusions: Rhabdomyomas were solely found in children. In adults, myxomas are the predominat cardiac tumors. Primary and metastasic malignant tumors are observed both in children and in adults (Rev Méd Chile 2006; 134: 1135-45).
Circulation, Nov 1, 1994
Origin of both coronary arteries from the pulmonary artery is generally a lethal condition from p... more Origin of both coronary arteries from the pulmonary artery is generally a lethal condition from progressive ventricular failure. We report the clinical and surgical course of two infants, ages 3 and 6 months, with this anomaly. One patient had normal intracardiac anatomy with low pulmonary artery pressures (30/12 mm Hg). The second patient had a restrictive subpulmonic ventricular septal defect with a moderately elevated pulmonary artery pressure (50/13 mm Hg). Left ventricular ejection and shortening fractions were profoundly depressed in both patients. The common coronary trunk arose from the right anterior facing sinus in one patient and from the left posterior facing sinus in the other. Both patients underwent repair by direct coronary implantation to the aorta. Left ventricular function improved with shortening fractions near normal at a follow-up of 6 months for one patient and 1 year for the other. Early diagnosis and prompt repair is compatible with survival and return of normal shortening fraction. (Circulation. 1994;90:2379-2384.) Key Words * congenital heart disease * coronary arteries * vessels * pulmonary artery
Revista chilena de obstetricia y ginecología, 2011
Journal of Perinatology, 2009
Objective: To evaluate whether early treatment with inhaled nitric oxide (iNO) will prevent newbo... more Objective: To evaluate whether early treatment with inhaled nitric oxide (iNO) will prevent newborns with moderate respiratory failure from developing severe hypoxemic respiratory failure (oxygenation index (OI)X40). Study Design: A total of 56 newborns with moderate respiratory failure (OI between 10 and 30) were randomized before 48 h after birth to early treatment with 20 p.p.m. of iNO (Early iNO group, n ¼ 28) or conventional mechanical ventilation with FiO 2 1.0 (Control group, n ¼ 28). Infants received iNO and/or high-frequency oscillatory ventilation (HFOV) if they developed an OI>40. Result: 7 of 28 early iNO patients (25%) compared to 17 of 28 control patients (61%) developed an OI>40 (P<0.05). In the Early iNO group mean OI significantly decreased from 22 (baseline) to 19 at 4 h (P<0.05) and remained lower over time: 19 (12 h), 18 (24 h) and 16 at 48 h. In contrast, OI increased in the Control group and remained significantly higher than the Early iNO group during the first 48 h of study: 22 (baseline), 29, 35, 32 and 23 at 4, 12, 24 and 48 h, respectively (P<0.01). Of 17, 6 control patients who developed an OI>40 were successfully treated with iNO. Nine of the remaining eleven control patients and six of seven Early iNO patients who had an OI>40 despite use of iNO responded with the addition of HFOV. One patient of the Early iNO group and two of the Control group died. Median (range) duration of oxygen therapy was significantly shorter in the Early iNO group: 11.5 (5 to 90) days compared to 18 (6 to 142) days of the Control group (P<0.03). Conclusion: Early use of iNO in newborns with moderate respiratory failure improves oxygenation and decreases the probability of developing severe hypoxemic respiratory failure.
Rev. chil. …, 1999
Base de dados : LILACS. Pesquisa : 244027 [Identificador único]. Referências encontradas : 1 [ref... more Base de dados : LILACS. Pesquisa : 244027 [Identificador único]. Referências encontradas : 1 [refinar]. Mostrando: 1 .. 1 no formato [Detalhado]. página 1 de 1, 1 / 1, LILACS, seleciona. para imprimir. Fotocópia. experimental, Documentos relacionados. Id: 244027. ...
Rev. chil. obstet. ginecol, 1996
... Id: 174923. Autor: Hernández Avalos, Alfredo; Urcelay M., Gonzalo; Oyarzún Ebensperger, Enriq... more ... Id: 174923. Autor: Hernández Avalos, Alfredo; Urcelay M., Gonzalo; Oyarzún Ebensperger, Enrique; Heusser Risopatrón, Felipe; Gormaz S., Gustavo; Arnaiz Gomez, Pilar; González B., Pedro; Vaccaro Cerva, Humberto; Tsunekawa O., Harumi; Chandía, Maggie. ...
The American Journal of Cardiology, 1995
We conclude that coronary artery fistulae may develop in patients undergoing right ventricular su... more We conclude that coronary artery fistulae may develop in patients undergoing right ventricular surgery and can be diagnosed during early postoperative echocardiographic evaluation. The most common site of drainage is the right ventricle. Careful imaging and color Doppler ...
Cardiovascular magnetic resonance findings in a pediatric population with isolated left ventricul... more Cardiovascular magnetic resonance findings in a pediatric population with isolated left ventricular non-compaction
Revista Española de Cardiología (English Edition), 2004
We present an alternative technique for closing multiple ventricular septal defects difficult to ... more We present an alternative technique for closing multiple ventricular septal defects difficult to access during surgery. A guidewire is advanced through the right ventricular free wall and through the main apical defect to the left ventricle, and this approach is used to place an Amplatzer device to occlude the ventricular septal defects. The procedure is performed in the beating heart, under intraoperative transesophageal echocardiographic guidance, and without extracorporeal circulation. It appears to be a simple and reproducible procedure with excellent short-term results.
Ultrasound in Medicine & Biology, 1997
Prenatal diagnonir of fetal cardiac abnormalities detected by lransvagimd echocardiography in ear... more Prenatal diagnonir of fetal cardiac abnormalities detected by lransvagimd echocardiography in early gestation.
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Papers by Gonzalo Urcelay