Papers by Sergio Carrillo
The Annals of thoracic surgery, Jan 30, 2015
One anatomic variant of pulmonary atresia with ventricular septal defect and major aortopulmonary... more One anatomic variant of pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals (PA/VSD/MAPCAs) is characterized by the absence of intrapericardial pulmonary arteries. This anatomy obviates the possibility of incorporating the pulmonary arteries for reconstruction or palliative procedures. The purpose of this study was to evaluate the surgical results in patients undergoing repair of PA/VSD/MAPCAs with absent pulmonary arteries. This was a retrospective review of 35 patients who underwent surgical repair of PA/VSD/MAPCAs with absent pulmonary arteries between 2007 and 2014. The median age at the time of surgery was 3.4 months, and the median weight was 4.9 kg. All patients underwent unifocalization of MAPCAs, with an average of 3.5 ± 1.4 MAPCAs per patient. Twenty-eight of the 35 patients (80%) underwent complete single-stage surgical repair, including unifocalization of MAPCAs, VSD closure, and right ventricle to pulmonary artery conduit. After complet...
The Annals of thoracic surgery, Jan 24, 2015
For many decades, patients with d-transposition of the great arteries underwent an atrial switch ... more For many decades, patients with d-transposition of the great arteries underwent an atrial switch procedure. Although many of these patients have continued to do well, a subset experience profound right ventricular failure. Some may be candidates for left ventricular (LV) retraining and late arterial switch. The purpose of this study was to review our experience with LV retraining and late arterial switch. This was a retrospective review of 32 patients with d-transposition. Thirty patients underwent a previous atrial switch and subsequently experienced right ventricular failure, whereas 2 presented late (8 months and 6 years) without previous intervention. The median age at the time of enrollment in this program was 15 years. Seven patients proceeded directly to late arterial switch owing to systemic LV pressures. The remaining 25 underwent a pulmonary artery band for LV retraining. Twenty of the 32 (63%) patients enrolled in this program were able to undergo a late arterial switch. ...
The Journal of thoracic and cardiovascular surgery, Jan 5, 2014
It is recognized that there are numerous anatomic variants that result in hypoplastic left heart ... more It is recognized that there are numerous anatomic variants that result in hypoplastic left heart physiology. One such variant includes critical aortic stenosis or atresia, a hypoplastic aortic arch, and a reasonably well-developed left ventricle due to the presence of a ventricular septal defect. These patients are candidates for 1 of 3 surgical options: (1) a Norwood procedure followed by a single-ventricle pathway; (2) a Norwood procedure followed by a Rastelli procedure (2-stage Yasui); or (3) a single-stage Yasui procedure. Because 2 of the 3 options include a Norwood procedure as the initial step, the purpose of this study was to evaluate the contemporaneous results of the Yasui and Norwood procedures at a single institution. This was a retrospective review of patients who underwent a Yasui or Norwood procedure at Lucile Packard Children's Hospital between 2004 and 2013. Eighteen patients underwent a Yasui, of whom 15 had a single-stage procedure and 3 had a 2-stage procedu...
Surgical Endoscopy, 2007
Background: Peritoneal dialysis is an alternate form of dialysis for patients with end-stage rena... more Background: Peritoneal dialysis is an alternate form of dialysis for patients with end-stage renal disease (ESRD). Although not as widely used as hemodialysis, peritoneal dialysis (PD) has clear advantages, especially those related to patient satisfaction and simplicity. The purpose of our study was to describe and look at the results of a microinvasive technique for placement of peritoneal dialysis catheters under laparoscopy. Methods: From August 2003 to January 2006, 12 patients with ESRD underwent laparoscopic-assisted peritoneal dialysis (LAPD) catheter placement with the microinvasive technique at our institution. Data collected included age, gender, underlying renal disease, and length of operation. Followup was completed for all patients (at least 6 months) and catheter-related morbidity and mortality were also analyzed. Results: There were 13 procedures performed (one patient had LAPD catheter placement twice). The average age was 45 years and the most common cause of ESRD was uncontrolled arterial hypertension. Procedural time averaged 33.6 min (range = 24-50 min). Peritoneal dialysis was introduced two weeks after the procedure and no dialysate leaks were observed. There were two catheter-related morbidities; both were catheter exit-site abscesses, one managed surgically with removal of the PD catheter and the other managed conservately with culture-sensitive antimicrobials. Patient satisfaction was beyond acceptable in 92% of the patients (12 of 13). Average longevity of the catheter was 61 weeks (427 days). There were no mortalities. Conclusion: LAPD catheter placement is an easy technique with acceptable catheter longevity and minimal morbidity. The microinvasive technique leads to better patient satisfaction and cosmetic outcome without affecting its function. Therefore, we believe that by promoting microinvasive LAPD catheter placement, PD will gain more acceptance among doctors and patients.
The Annals of Thoracic Surgery, 2012
The 5-year survival for patients with resected stage II (N1) non-small cell lung cancer ranges fr... more The 5-year survival for patients with resected stage II (N1) non-small cell lung cancer ranges from 40% to 55%. No data exist addressing the benefit of neoadjuvant therapy for patients with stage II disease. This is largely in part due to the lack of a reliable, minimally invasive method to assess hilar nodes. This study is aimed at determining the ability of fusion positron emission/computed tomography (PET/CT) to identify hilar metastases in patients with resected non-small cell lung cancer. A retrospective review of surgically resected patients with fusion PET/CT within 30 days of resection was performed. The sensitivity, specificity, positive predictive value, and negative predictive value for PET/CT in detecting hilar nodal metastases was calculated for a range of maximum standardized uptake values (SUVmax). Hilar nodes from patients with falsely positive PET/CT scans were analyzed for the presence of histoplasmosis. Additionally, the impact of hilar node size greater than 1 centimeter on the calculated values was assessed. There were 119 patients evaluated. The number of lymph nodes resected ranged from 1 to 12 (X=2.98). There was decreased sensitivity and increased specificity with higher SUVmax cutoff values. At the standard SUVmax value of 2.5, the sensitivity and specificity were only 48.5% and 80.2%. The addition of size of hilar node by CT led to a modest improvement in sensitivity at all SUVmax cutoff values. Fusion PET/CT lacks sensitivity and specificity in identifying hilar nodal metastasis in patients with resected non-small cell lung cancer. Further prospective studies assessing the utility of PET/CT versus alternative sampling techniques are warranted.
• Unidad física fundamental de la herencia cuya existencia se puede confirmar por variantes aléli... more • Unidad física fundamental de la herencia cuya existencia se puede confirmar por variantes alélicas y que ocupa un locus cromosómico concreto. Secuencia de cromosómico concreto. Secuencia de DNA que codifica para un polipéptido. • Un alelo es uno de los posibles estados mutacionales de un gen, diferente de otros alelos por sus efectos fenotípicos.
Colesterol es necesario para el mantenimiento sano de nuestros tejidos.
El Colesterol es un tipo de grasa que existe en el organismo y que poseemos todas las personas. D... more El Colesterol es un tipo de grasa que existe en el organismo y que poseemos todas las personas. De hecho dependemos del colesterol para, entre otras cosas, poder fabricar la membrana de las células, para formar las sales biliares y para elaborar algunos tipos de hormonas tan importantes como son las hormonas sexuales y las hormonas glucocorticoides y mieneralocorticoides, que nos sirven para controlar la Tensión Arterial y para defendernos de las agresiones externas o internas.
Este sistema se integra con el corazón, que se encarga de bombear sangre a dos circuitos:
a la homeostasis de otros aparatos y sistemas del organismo a través del transporte y distribució... more a la homeostasis de otros aparatos y sistemas del organismo a través del transporte y distribución de la sangre a lo largo del cuerpo entregando sustancias (como oxigeno, nutrientes y hormonas) y retirando los desechos. Las Venas son vasos sanguíneos de paredes finas y preparadas para soportar baja presión a través de los cuales la sangre retorna al corazón. Se originan mediante pequeños ramos en las redes capilares y siguen dirección contraria a la de las arterias. El diámetro de las venas varía entre 0,1mm y más de 1 mm. Las venas son de mayor volumen que las arterias el volumen de las venas varia con la constitución individual, siendo mas gruesas en los individuos delgados que en los gordos, y varia también, con varios sistemas, con ciertos estados fisiológicos, como el esfuerzo, la agitación, etc. A pesar de que las venas están compuestas esencialmente por las 3 mismas capas (túnicas) que las arterias el espesor relativo de las capas es diferente. La túnica interna de las venas es mas delgada que la de las arterias; la túnica media de las venas es mucho mas delgada que en las arterias, con relativamente poco músculo liso y fibras elásticas. La túnica externa de las venas es la capa más gruesa y esta formada por fibras elásticas y colágeno. 1 2 ( 1 Tortora J. G., Derrickson B. El Aparato Circulatorio: vasos sanguíneos y hemodinamia;
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Papers by Sergio Carrillo