Education

Undergraduate School

University of Puerto Rico
1971 San Juan PR

Medical School

University of Puerto Rico School of Medicine
1975 San Juan PR

Fellowship

Pediatric Cardiology; Clinical Intracardiac Electrophysiology University of Miami School of Medicine
1980 Miami FL

Residency

Anesthesia University of Texas Medical Branch
1993 Galveston TX

Fellowship

Pediatric Anesthesia Boston Children's Hospital
1995 Boton MA

Publications

  1. Pulmonary hypertension manifesting as atrial arrhythmia in an anesthetized child; Diagnosis using focused cardiac ultrasound. Paediatr Anaesth. 2019 08; 29(8):884-885. View Abstract
  2. Pausing With the Gauze: Inhibition of Temporary Pacemakers by Radiofrequency Scan During Cardiac Surgery. Anesth Analg. 2016 11; 123(5):1143-1148. View Abstract
  3. Institutional Policy Changes to Prevent Cardiac Toxicity Associated With Bupivacaine Penile Blockade in Infants. A A Case Rep. 2016 Aug 01; 7(3):71-5. View Abstract
  4. Anesthetic management of noncardiac surgery for patients with single ventricle physiology. J Anesth. 2011 Apr; 25(2):247-56. View Abstract
  5. The needle and the damage done: pericardial effusion with tamponade after needle ingestion in an infant. J Laryngol Otol. 2009 Dec; 123(12):1396-8. View Abstract
  6. Management of difficult airway in pediatric patients with right ventricular outflow tract obstruction. J Anesth. 2009; 23(2):281-3. View Abstract
  7. Management of difficult airway in pediatric patients with right ventricular outflow tract obstruction. J Anesth. 2009; 23:281-283. View Abstract
  8. The needle and the damage done: pericardial effusion with tamponade after needle ingestion in an infant. J Laryngol Otol. 2009; 123(12):1396-8. View Abstract
  9. Anesthesia for Heart and Lung Transplantation. Essentials of Cardiac Anesthesia, Kaplan, Reich, Lake, Konstadt, eds. 2008; in press. View Abstract
  10. Anesthesia for heart, lung, and heart-lung transplantation. Essentails of Cardiac Anesthesia, Joel A. Kaplan, Editor. 2008; 463-491. View Abstract
  11. Migration of an ingested foreign body to the mediastinum complicated by a pericardial effusion. Anesthesiology. 2008; 109:A168. View Abstract
  12. Intraoperative alertness of a rise in serum potassium by double counting of the heart rate during blood transfusion in an infant. Pediatr Anesth. 2008; 18:798-9. View Abstract
  13. The cone procedure for severe Ebstein's anomaly in an infant: periopertative management. Anesthesiology. 2008; 109:A169. View Abstract
  14. Cardiac arrest after neuromuscular blockade reversal in a heart transplant infant. Anesthesiology. 2007 Oct; 107(4):663-5. View Abstract
  15. The frequency of anesthesia-related cardiac arrests in patients with congenital heart disease undergoing cardiac surgery. Anesth Analg. 2007 Aug; 105(2):335-43. View Abstract
  16. Induction of supraventricular tachycardia during transesophageal echocardiography: an unusual complication. J Cardiothorac Vasc Anesth. 2008 Aug; 22(4):592-3. View Abstract
  17. Perioperative myocardial ischemia in pediatric cardiac patients undergoing non-cardiac surgery. Anesthesiology. 2007; 107:A220. View Abstract
  18. Management of right ventricular outflow tract reactivity following pulmonary valve dilatation under general anesthesia: experience of a medical mission. Paediatr Anaesth. 2006 Oct; 16(10):1087-9. View Abstract
  19. Use of nitric oxide for treatment of pulmonary hypertensive crisis in a child after protamine administration. J Cardiothorac Vasc Anesth. 2006 Oct; 20(5):719-21. View Abstract
  20. Use of dexmedetomidine in children after cardiac and thoracic surgery. Pediatr Crit Care Med. 2006 Mar; 7(2):126-31. View Abstract
  21. Anesthesia for Heart, Lung and Heart-lung Transplantation. Kaplan's Cardiac Anesthesia. Kaplan, Reich, Lake, Konstadt, eds. 2006; 845-65. View Abstract
  22. Problems in Pediatric Anesthesia. Anesth Analg. 2005; 100:1550. View Abstract
  23. Use of nitric oxide for treatment of pulmonary hypertensive crisis in a child after protamine administration. Anesthesiology. 2004; A1461. View Abstract
  24. Use of dexmedetomidine after congenital cardiac surgery. Cardiology in the Young 2004. 2004; 14 (Suppl 2):Abstract P 105. View Abstract
  25. Closed correction of systemic semilunar valve insufficiency in the neonate. J Thorac Cardiovasc Surg. 2003 Nov; 126(5):1650-2. View Abstract
  26. Stress response in infants undergoing cardiac surgery: a randomized study of fentanyl bolus, fentanyl infusion, and fentanyl-midazolam infusion. Anesth Analg. 2001 Apr; 92(4):882-90. View Abstract
  27. Parameters associated with perioperative baffle fenestration closure in the Fontan operation. J Cardiothorac Vasc Anesth. 2000 Oct; 14(5):553-6. View Abstract
  28. Intraoperative recurrent laryngeal nerve monitoring during video-assisted throracoscopic surgery for patent ductus arteriosus. J Cardiothorac Vasc Anesth. 2000 Oct; 14(5):562-4. View Abstract
  29. Use of plastic-coated stylets for endotracheal intubation. J Pediatr. 2000 May; 136(5):705. View Abstract
  30. Attempted placement of a thoracic epidural catheter via the caudal route in a newborn. Anesthesiology. 1999 Dec; 91(6):1965-6. View Abstract
  31. Cardiovascular evaluation in thoracopagus twins. Circulation. 1999 Jul 06; 100(1):103. View Abstract
  32. Electrocardiographic inscription of diaphragmatic contractions during anaesthesia. Paediatr Anaesth. 1999; 9(2):175-6. View Abstract
  33. Rick for cerebral emboli and ECG changes following minimal access surgery for closure of atrial septal defect in children. Acta Anesth Scand. 1999; 43 (Suppl 114):105. View Abstract
  34. A randomized study of fentanyl bolus, fentanyl infusion and fentanyl-midazolam infusion for infant cardiac surgery- clinical outcome. Anesthesiology. 1999; 91(3A):A1285. View Abstract
  35. Stress response in infants undergoing cardiac surgery: A randomized study of fentanyl bolus, fentanyl infusion and fentanyl-medazolam infusion. Anesthesiology. 1999; 91(3A):A1284. View Abstract
  36. Factors associated with baffle fenestration closure in Fontan operation. Circulation. 1998; 98 (Suppl I):339. View Abstract
  37. Perioperative white matter degeneration and death in a patient with a defect in mitochondrial oxidative phosphorylation. Anesthesiology. 1997 Aug; 87(2):420-5. View Abstract
  38. Acute intraoperative endotracheal tube obstruction associated with a heat and moisture exchanger in an infant. Anesth Analg. 1997 Apr; 84(4):939-40. View Abstract
  39. Electrocardiographic demonstration of dual atrioventricular nodal pathways in children. P R Health Sci J. 1991 Dec; 10(3):143-4. View Abstract
  40. Induction of wide QRS tachycardia during transthoracic echocardiography. J Am Soc Echocardiogr. 1991 Nov-Dec; 4(6):623-4. View Abstract
  41. Mitral valve prolapse in juvenile thyrotoxicosis. P R Health Sci J. 1991 Aug; 10(2):71-3. View Abstract
  42. Echocardiographic assessment of the right atrioventricular junction in Ebstein's malformation. P R Health Sci J. 1990 Dec; 9(3):231-3. View Abstract
  43. Late arrhythmias and outcome in patients after the Mustard operation for transportation of the great arteries: Update of 1981 pediatric electrophysiology group collaborative study . Circulation. 1990; 82 (Suppl III):223. View Abstract
  44. Cor triatriatum sinister: echocardiographic assessment. P R Health Sci J. 1989 Aug; 8(2):263-4. View Abstract
  45. Ventricular septal defect closure in infancy: results from a smaller tertiary referral center. Clinical Research. 1989; 37:43A. View Abstract
  46. Effective use of urokinase for central venous catheter thrombosis in premature infants. Guided by Dopplar ultrasound. Clinical Research. 1989; 37:65A. View Abstract
  47. Successful urokinase therapy for superior vena cava syndrome in a premature infant. Am J Dis Child. 1988 Dec; 142(12):1267-8. View Abstract
  48. Echo Doppler detection of external compression of the vertical vein causing obstruction in total anomalous pulmonary venous connection. Am Heart J. 1988 Oct; 116(4):1045-7. View Abstract
  49. Atrial septal aneurysm herniation across the mitral valve orifice in pulmonary atresia. Am Heart J. 1988 May; 115(5):1136-8. View Abstract
  50. Ectopic automatic atrial tachycardia in children: clinical characteristics, management and follow-up. J Am Coll Cardiol. 1988 Feb; 11(2):379-85. View Abstract
  51. Atrial septal aneurysms and tachycardia in fetuses and newborn infants. Clinical Research. 1988; 36:49A. View Abstract
  52. Evaluating Pediatric Arrhythmias. Family Practice Recertification. 1988; 10:25-53. View Abstract
  53. Hypoplasia of the left coronary artery complicated by reversible myocardial ischemia in a newborn. Am Heart J. 1987 Nov; 114(5):1238-41. View Abstract
  54. Pulmonary atresia with intact ventricular septum. J Am Coll Cardiol. 1987 Aug; 10(2):477-8. View Abstract
  55. The interpretation and medical management of complex arrhythmias in the newborn infant. P R Health Sci J. 1987 Aug; 6(2):73-9. View Abstract
  56. Gift to a litigious society. Pediatrics. 1987 Jul; 80(1):127. View Abstract
  57. Atrial septal aneurysms in infants and children. Am Heart J. 1987 May; 113(5):1149-53. View Abstract
  58. Acquired pulmonary atresia following placement of modified Blalock-Taussig shunt in tetralogy of Fallot. Int J Cardiol. 1987 May; 15(2):244-7. View Abstract
  59. False division of the left atrium by a redundant, mobile flap valve of the foramen ovale: echocardiographic and anatomic assessment in a neonate with critical pulmonic stenosis. Am Heart J. 1987 Apr; 113(4):1032-5. View Abstract
  60. Hypoplasia of the left coronary artery complicated by reversible myocardial ischemia in a newborn: differentiation from other coronary artery anomalies. Clinical Research. 1987; 35:50A. View Abstract
  61. Tuberous sclerosis and Wolff-Parkinson-White syndrome. J Pediatr. 1986 Aug; 109(2):399-400. View Abstract
  62. Left ventricular bands (false tendons): echocardiographic and angiocardiographic delineation in children. Am Heart J. 1986 Feb; 111(2):321-4. View Abstract
  63. Effects of right and left atrial stimulation on atrioventricular conduction in children. Pediatr Cardiol. 1986; 6(5):245-8. View Abstract
  64. Anomalous origin and malposition of the pulmonary arteries (crisscross pulmonary arteries) associated with complex congenital heart disease. Pediatr Cardiol. 1986; 6(5):287-91. View Abstract
  65. Atrial septal aneurysms in infants. Clinical Research. 1986; 34:234A. View Abstract
  66. Vagatonia as a cause of syncope. J Pediatr. 1986; 109:399-400. View Abstract
  67. Cardiomyopathy associated with severe thermal burns in children and adolescents. Clinical Research. 1986; 34:234A. View Abstract
  68. Fast-slow atrioventicular nodal tachycardia in children. Pediatric Research. 1986. View Abstract
  69. Propranolol serum pharmacokinetics in infants under one year of age: inadequate assessment without tracer isotope methodology or prolonged terminal elimination phase sampling. Pediatric Research. 1986. View Abstract
  70. Pericarditis due to drug allergy. Clinical Research. 1986; 34:234A. View Abstract
  71. Pulmonary and subclavian steal following Blalock-Taussig shunt. Am Heart J. 1985 Dec; 110(6):1313-4. View Abstract
  72. Successful management of atrial flutter in a newborn with verapamil. Clin Cardiol. 1985 Nov; 8(11):597-8. View Abstract
  73. Vagotonia in infants, children, adolescents and young adults. Int J Cardiol. 1985 Oct; 9(2):211-24. View Abstract
  74. Aneurysm of the interatrial septum. J Am Coll Cardiol. 1985 Oct; 6(4):956. View Abstract
  75. Is there a thyrotoxic cardiomyopathy in children? J Pediatr. 1985 Oct; 107(4):531-6. View Abstract
  76. Nonsustained atrial flutter in a child without congenital heart disease. Clin Cardiol. 1985 Oct; 8(10):545-6. View Abstract
  77. Aberrant systemic artery-pulmonary vein fistula: detection of an occult lesion by contrast echocardiography. Am Heart J. 1985 Aug; 110(2):480-2. View Abstract
  78. Absent right atrioventricular connexion with the left atrium connected to the morphologically right ventricle, a right-sided rudimentary left ventricle, and right juxtaposition of the atrial appendages: documentation by angiography and cross-sectional echocardiography. Int J Cardiol. 1985 Jan; 7(1):21-8. View Abstract
  79. Left ventricular false tendons (bands): echocardiographic and angiocardiographic delineation. Pediatric Research. 1985; 19:125A. View Abstract
  80. Functional thyrotoxic cardiomyopathy in children. Pediatric Research. 1985; 19:125A. View Abstract
  81. Calcification of the ascending aorta and aortic and mitral valves in Gaucher's disease. Am J Cardiol. 1984 Dec 01; 54(10):1390-1. View Abstract
  82. Hemoptysis following Mustard repair: a late complication. Clin Cardiol. 1984 Dec; 7(12):673-7. View Abstract
  83. Diastolic atrial compression in a premature infant. J Am Coll Cardiol. 1984 Nov; 4(5):1069-71. View Abstract
  84. Cardiac rhythm after the Mustard operation for complete transposition of the great arteries. N Engl J Med. 1984 Jun 21; 310(25):1635-8. View Abstract
  85. Cardiac complications in juvenile hyperthyroidism. Am J Dis Child. 1984 May; 138(5):479-82. View Abstract
  86. Induction of nonsustained atrial flutter by programmed atrial stimulation in children: incidence, mechanisms, and clinical implications. Am Heart J. 1984 Mar; 107(3):444-8. View Abstract
  87. Hemodynamic and cardiovascular effect of halothane and isoflurane anesthesia in children. Pediatr Cardiol. 1984; 5:263. View Abstract
  88. Electrophysiological studies before and after cardia angiography in children: A comparative evaluation. Clinical Research. 1984; 32:378. View Abstract
  89. Bilateral ocular compression during EKG monitoring: A prospective study to evaluate vagal tone in children. Pediatric Research. 1984; 18(4):120A. View Abstract
  90. Echocardiographic and angiocardiographic demonstration of redundant mitral valve tissue in Teschler/Nicola-Kilian syndrome. Clinical Research. 1984; 32:885A. View Abstract
  91. Responses of hyperthyroid children to exercise. Pediatric Research. 1984; 4:120A. View Abstract
  92. His-Purkinje electrophysiological characteristics in children with heart defects. Pediatric Research. 1984; 18(4):120A. View Abstract
  93. Electrophysiological evaluation in patients with coarctation of the aorta. Pediatric Research. 1984; 4:120A. View Abstract
  94. Vasovagal syncope in children requiring pacemaker implantation. Am Heart J. 1983 Dec; 106(6):1406-11. View Abstract
  95. Multiple atrioventricular nodal pathways--a new electrophysiological phenomenon in children. J Electrocardiol. 1983 Oct; 16(4):331-7. View Abstract
  96. Prolongation of Q-T interval and increased amplitude of the T wave after termination of ventricular tachycardia. Am J Cardiol. 1983 May 01; 51(8):1467. View Abstract
  97. True congenital aneurysm of the septum primum not associated with obstructive right- or left-sided lesions: identified by two-dimensional echocardiography and angiography in a newborn. Pediatr Cardiol. 1983 Apr-Jun; 4(2):159-62. View Abstract
  98. Subclavian-artery-to-innominate-vein fistula presenting with congestive failure in a newborn infant. Pediatr Cardiol. 1983 Apr-Jun; 4(2):155-7. View Abstract
  99. Delineation of tunnel-like-ventricular septal defects in young children by axial cineangiography. Eur J Pediatr. 1983 Mar; 140(1):13-6. View Abstract
  100. Hemodynamics and intracardiac conduction after operative repair of tetralogy of Fallot. Am J Cardiol. 1983 Feb; 51(3):552-6. View Abstract
  101. Massive dilatation of the atria and coronary sinus in a child with restrictive cardiomyopathy and persistence of the left superior vena cava. Cathet Cardiovasc Diagn. 1983; 9(1):47-53. View Abstract
  102. Assessment of vagal tone in children by bilateral ocular compression during EKG monitoring: A prospective evaluation. Clinical Research. 1983; 31(5):890A. View Abstract
  103. Cardiac complications of juvenile hyperthyroidism relationship with duration and treatment. Pediatric Research. 1983; 17(4):159A. View Abstract
  104. Natural history of supraventricular rhythms in 192 children following the Mustard operation: a collaborative multi-center study. J Am Coll Cardiol. 1983; 1(62):613. View Abstract
  105. Enhanced detection of cardiac disease in mucopolysaccharidosis by combined M-mode and two-dimensional echocardiographic examination. Clinical Research. 1983; 31(5):891A. View Abstract
  106. Right ventricular apical activation time in children, reference standard for clinical use. Cardiology Digest. 1983; 6:13. View Abstract
  107. Captropril for management of paradoxical hypertension after coarctation repair. Pediatric Research. 1983; 17(4):110A. View Abstract
  108. Left ventricular function and reserve in childhood Grave's disease. Clinical Research. 1983; 31(5):893A. View Abstract
  109. Supraventricular Tachycardia in Children. Roberts N. Gelband H, eds. <i>Cardiac Arrhythmias in the Neonate, Infant and Child.</i>. New York: Appleton-Century-Crofts. 1983; 105-46. View Abstract
  110. Atrial flutter in the young: a collaborative study of 380 cases. Pediatric Cardiol. 1983; 4:305-17. View Abstract
  111. Determination of His-Purkinje electrophysiological characteristics in children with heart defects. Clinical Research. 1983; 31(5):890A. View Abstract
  112. Procainamide elimination kinetics in pediatric patients. Clin Pharmacol Ther. 1982 Nov; 32(5):607-11. View Abstract
  113. Effective use of captopril in postoperative paradoxical hypertension of coarctation of the aorta. Clin Cardiol. 1982 Oct; 5(10):551-3. View Abstract
  114. Capsular stroke in congenital complete heart block. Eur J Pediatr. 1982 Sep; 139(1):71-2. View Abstract
  115. Echocardiography and congenital arteriovenous malformations. Am J Cardiol. 1982 Apr 01; 49(5):1375. View Abstract
  116. Decorticate posture following 'cardiac cocktail': a transient complication of sedation for catheterization. Pediatr Cardiol. 1982; 2(3):251-3. View Abstract
  117. Bacterial endocarditis and renal failure in a 10-year-old boy. Pediatr Cardiol. 1982; 2(3):259-62. View Abstract
  118. Sinus and atrioventricular nodal function: Preoperative and early postoperative assessment in children. J Thorac Cardiovasc Surg. 1982 Jan; 83(1):141-8. View Abstract
  119. Right ventricular apical activation time in children. Reference standards for clinical use. Pediatr Cardiol. 1982; 2(1):47-9. View Abstract
  120. Effects of right and left atrial stimulation on atrial refractory periods and A-V nodal conduction. Pediatric Research. 1982; 16(4):97A. View Abstract
  121. Effects of right and left atrial stimulation on atrial refractory periods and atrioventricular node conduction. Pediatr Cardiol. 1982; 3(4):352-3. View Abstract
  122. Atrial flutter inducec by programmed stimulation in dysrhythmia- free children: incidence, mechanism and significance. Circulation. 1982; 66:170. View Abstract
  123. Verapamil for PSVT in patients with WPW. J Pediatr. 1981 Sep; 99(3):502-3. View Abstract
  124. Determinants of ventricular refractory periods in children with congenital heart disease: effects of cycle length and age. Am Heart J. 1981 Jul; 102(1):75-9. View Abstract
  125. His-Purkinje responses and refractory periods during atrial extrastimulation in children with heart defects. Circulation. 1981 Jun; 63(6):1383-90. View Abstract
  126. Echocardiographic assessment of right bundle branch injury after repair of tetralogy of Fallot. Circulation. 1981 Jan; 63(1):174-80. View Abstract
  127. Comparison of right and left atrial refractory periods in dysrhythmia-free children. Clinical Research. 1981; 29(5):875A. View Abstract
  128. Multiple atrioventicular nodal pathways: a new electrophysiological phenomenon in children. Am J Cardiol. 1981; 47:440. View Abstract
  129. Dual atrioventricular nodal pathways: a benign finding in arrhythmia-free children with heart disease. Am J Cardiol. 1980 Dec 01; 46(6):1013-8. View Abstract
  130. Prostaglandin E1 in the neonate with heart disease. Adv Prostaglandin Thromboxane Res. 1980; 7:879-81. View Abstract
  131. Dual atrioventicular nodal pathway conduction- a common electrophysiological phenomenon in children without arrhythmias. Am J Cardiol. 1980; 45:430. View Abstract
  132. Intracardiac conduction and hemodynamis studies in children with arrhythmias after surgery for tetralogy of Fallot. Clinical Research. 1980; 28(5):850A. View Abstract
  133. Changes in cycle length, conduction times and refractory periods induced by sedation with meperidine, promethazine and chlorpromazine. Dev Pharmacol Ther. 1980; 1:339-51. View Abstract
  134. Changes in the atrial component of atrioventricular conduction induced by sedation with meperidine, promethazine, and chlorpromazine. Clinical Research. 1980; 28(5):850A. View Abstract
  135. Ventricular refractory periods in pre and postoperative cardiac patients. Pediatric Research. 1980; 14(4):137. View Abstract
  136. Dilatation of the descending aorta: a radiologic and echocardiographic diagnostic sign in arteriovenous malformations in neonates and young infants. Am J Cardiol. 1979 Sep; 44(3):493-7. View Abstract
  137. Dual atrioventicular nodal pathways in children without arrhythmias. Clinical Research. 1979; 27(5):769. View Abstract
  138. Changes in cycle length, conduction times, and refractor periods induced by sedation with meperidine, promethazine and chlorpromazine. Am J Cardiol. 1979; 43:425. View Abstract

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