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54. Heart transplantation after donor circulatory death in patients bridged to transplant with implantable left ventricular assist devices

Author

García Sáez, Diana, primary, Bowles, Christopher T., additional, Mohite, Prashant N., additional, Zych, Bartlomiej, additional, Maunz, Olaf, additional, Popov, Aron F., additional, Hurtado, Ana, additional, Raj, Binu, additional, Rahman-Haley, Shelley, additional, Banner, Nicholas, additional, and Simon, Andre R., additional

Published
2016
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56. Surgical treatment of infective endocarditis in active intravenous drug users: a justified procedure?

Author

Weymann, Alexander, Borst, Tobias, Popov, Aron-Frederik, Sabashnikov, Anton, Bowles, Christopher, Schmack, Bastian, Veres, Gabor, Chaimow, Nicole, Simon, Andre Rüdiger, Karck, Matthias, and Szabo, Gábor

Subjects
Surgery, Cardiology and Cardiovascular Medicine
Abstract

Background Infective endocarditis is a life threatening complication of intravenous drug abuse, which continues to be a major burden with inadequately characterised long-term outcomes. We reviewed our institutional experience of surgical treatment of infective endocarditis in active intravenous drug abusers with the aim of identifying the determinants long-term outcome of this distinct subgroup of infective endocarditis patients. Methods A total of 451 patients underwent surgery for infective endocarditis between January 1993 and July 2013 at the University Hospital of Heidelberg. Of these patients, 20 (7 female, mean age 35 ± 7.7 years) underwent surgery for infective endocarditis with a history of active intravenous drug abuse. Mean follow-up was 2504 ± 1842 days. Results Staphylococcus aureus was the most common pathogen detected in preoperative blood cultures. Two patients (10%) died before postoperative day 30. Survival at 1, 5 and 10 years was 90%, 85% and 85%, respectively. Freedom from reoperation was 100%. Higher NYHA functional class, higher EuroSCORE II, HIV infection, longer operating time, postoperative fever and higher requirement for red blood cell transfusion were associated with 90-day mortality. Conclusions In active intravenous drug abusers, surgical treatment for infective endocarditis should be performed as extensively as possible and be followed by an aggressive postoperative antibiotic therapy to avoid high mortality. Early surgical intervention is advisable in patients with precipitous cardiac deterioration and under conditions of staphylococcal endocarditis. However, larger studies are necessary to confirm our preliminary results. peerReviewed

Published
2014

58. Ex vivo heart perfusion after cardiocirculatory death; a porcine model

Author

García Sáez, Diana, primary, Elbetanony, Ahmed, additional, Lezberg, Paul, additional, Hassanein, Amira, additional, Bowles, Christopher T., additional, Popov, Aron-Frederik, additional, Zych, Bartlomiej, additional, Sabashnikov, Anton, additional, Mohite, Prashant, additional, and Simon, Andre R., additional

Published
2015
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61. Evaluation of the Organ Care System in Heart Transplantation With an Adverse Donor/Recipient Profile

Author

García Sáez, Diana, primary, Zych, Bartlomiej, additional, Sabashnikov, Anton, additional, Bowles, Christopher T., additional, De Robertis, Fabio, additional, Mohite, Prashant N., additional, Popov, Aron-Frederik, additional, Maunz, Olaf, additional, Patil, Nikhil P., additional, Weymann, Alexander, additional, Pitt, Timothy, additional, McBrearty, Louise, additional, Pates, Bradley, additional, Hards, Rachel, additional, Amrani, Mohamed, additional, Bahrami, Toufan, additional, Banner, Nicholas R., additional, and Simon, Andre R., additional

Published
2014
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62. Outcomes after implantation of partial-support left ventricular assist devices in inotropic-dependent patients: Do we still need full-support assist devices?

Author

Sabashnikov, Anton, primary, Popov, Aron-Frederik, additional, Bowles, Christopher T., additional, Mohite, Prashant N., additional, Weymann, Alexander, additional, Hards, Rachel, additional, Hedger, Mike, additional, Wittwer, Thorsten, additional, Wippermann, Jens, additional, Wahlers, Thorsten, additional, Schoendube, Friedrich A., additional, and Simon, André R., additional

Published
2014
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63. De Novo Aortic Regurgitation After Continuous-Flow Left Ventricular Assist Device Implantation

Author

Patil, Nikhil Prakash, primary, Sabashnikov, Anton, additional, Mohite, Prashant N., additional, Garcia, Diana, additional, Weymann, Alexander, additional, Zych, Bartlomiej, additional, Bowles, Christopher T., additional, Hards, Rachel, additional, Hedger, Michael, additional, Popov, Aron F., additional, De Robertis, Fabio, additional, Moza, Ajay, additional, Bahrami, Toufan, additional, Amrani, Mohamed, additional, Rahman-Haley, Shelley, additional, Banner, Nicholas R., additional, and Simon, André Rüdiger, additional

Published
2014
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65. First Experience With the Synergy Micro‐Pump in Patients in INTERMACS Class 1–2 as a Bridge to Transplantation: Pushing the Limits?

Author

Sabashnikov, Anton, primary, Popov, Aron‐Frederik, additional, Bowles, Christopher T., additional, Weymann, Alexander, additional, Mohite, Prashant N., additional, Wahlers, Thorsten, additional, Wittwer, Thorsten, additional, Zych, Bartlomiej, additional, Garcia‐Saez, Diana, additional, Patil, Nikhil P., additional, Fatullayev, Javid, additional, Amrani, Mohamed, additional, Banner, Nicholas R., additional, Seidler, Tim, additional, Unsoeld, Bernhard, additional, Bireta, Christian, additional, Schoendube, Friedrich A., additional, and Simon, André R., additional

Published
2014
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66. Central extracorporeal life support with left ventricular decompression for the treatment of refractory cardiogenic shock and lung failure

Author

Weymann, Alexander, primary, Schmack, Bastian, additional, Sabashnikov, Anton, additional, Bowles, Christopher T, additional, Raake, Philipp, additional, Arif, Rawa, additional, Verch, Markus, additional, Tochtermann, Ursula, additional, Roggenbach, Jens, additional, Popov, Aron Frederik, additional, Simon, Andre Ruediger, additional, Karck, Matthias, additional, and Ruhparwar, Arjang, additional

Published
2014
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71. Investigation of the Characteristics of Heart Ware HVAD and Thoratec Heart Mate II Under Steady and Pulsatile Flow Conditions.

Author

Noor, Mumin R., Ho, Chong H., Parker, Kim H., Simon, Andre R., Banner, Nicholas R., and Bowles, Christopher T.

Subjects
HEART ventricle diseases, HEART assist devices, PULSATILE flow, DEXTROSE, HEART beat, BLOOD testing, THERAPEUTICS
Abstract

The aim of this study was to elucidate the dynamic characteristics of the Thoratec Heart Mate II ( HMII) and the Heart Ware HVAD ( HVAD) left ventricular assist devices ( LVADs) under clinically representative in vitro operating conditions. The performance of the two LVADs were compared in a normothermic, human blood-filled mock circulation model under conditions of steady (nonpulsatile) flow and under simulated physiologic conditions. These experiments were repeated using 5% dextrose in order to determine its suitability as a blood analog. Under steady flow conditions, for the HMII, approximately linear inverse LVAD differential pressure ( H) versus flow ( Q) relationships were observed with good correspondence between the results of blood and 5% dextrose under all conditions except at a pump speed of 9000 rpm. For the HVAD, the corresponding relationships were inverse curvilinear and with good correspondence between the blood-derived and 5% dextrose-derived relationships in the flow rate range of 2-6 L/min and at pump speeds up to 3000 rpm. Under pulsatile operating conditions, for each LVAD operating at a particular pump speed, an counterclockwise loop was inscribed in the HQ domain during a simulated cardiac cycle ( HQ loop); this showed that there was a variable phase relationship between LVAD differential pressure and LVAD flow. For both the HMII and HVAD, increasing pump speed was associated with a right-hand and upward shift of the HQ loop and simulation of impairment of left ventricular function was associated with a decrease in loop area. During clinical use, not only does the pressure differential across the LVAD and its flow rate vary continuously, but their phase relationship is variable. This behavior is inadequately described by the widely accepted representation of a plot of pressure differential versus flow derived under steady conditions. We conclude that the dynamic HQ loop is a more meaningful representation of clinical operating conditions than the widely accepted steady flow HQ curve. [ABSTRACT FROM AUTHOR]

Published
2016
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75. Reversal of Severe Heart Failure With a Continuous-Flow Left Ventricular Assist Device and Pharmacological Therapy

Author

Birks, Emma J., primary, George, Robert S., additional, Hedger, Mike, additional, Bahrami, Toufan, additional, Wilton, Penny, additional, Bowles, Christopher T., additional, Webb, Carole, additional, Bougard, Robert, additional, Amrani, Mohammed, additional, Yacoub, Magdi H., additional, Dreyfus, Gilles, additional, and Khaghani, Asghar, additional

Published
2011
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81. Hemodynamic and Echocardiographic Responses to Acute Interruption of Left Ventricular Assist Device Support: Relevance to Assessment of Myocardial Recovery

Author

George, Robert S., primary, Yacoub, Magdi H., additional, Tasca, Giordano, additional, Webb, Carole, additional, Bowles, Christopher T., additional, Tansley, Patrick, additional, Hardy, James P., additional, Dreyfus, Gilles, additional, Khaghani, Asghar, additional, and Birks, Emma J., additional

Published
2007
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89. Quantitative Myocardial Cytokine Expression and Activation of the Apoptotic Pathway in Patients Who Require Left Ventricular Assist Devices

Author

Birks, Emma J., primary, Latif, Najma, additional, Owen, Virginia, additional, Bowles, Christopher, additional, Felkin, Leanne E., additional, Mullen, Anthony J., additional, Khaghani, Asghar, additional, Barton, Paul J.R., additional, Polak, Julia M., additional, Pepper, John R., additional, Banner, Nicholas R., additional, and Yacoub, Magdi H., additional

Published
2001
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97. Discovering marine terraces using airborne LiDAR along the Mendocino-Sonoma coast, northern California.

Author

Bowles, Christopher J. and Cowgill, Eric

Subjects
*TERRACES (Geology), *OPTICAL radar, *GEOLOGY
Abstract

Marine terraces are landforms that record both paleohorizontal and true surface uplift above mean sea level, and thus serve as longbaseline geodetic markers. Here we present a method for extending terrace records back in time by analyzing 2003 National Aeronautics and Space Administration (NASA) airborne LiDAR data to discover a suite of probable marine terraces along a 70-kmlong section of the northern California coast. In particular, we present a semiautomated surface classification model, based on slope and surface roughness properties, to identify low-slope and low-relief topographic platforms with characteristics similar to marine terraces. Between Fort Ross and Point Arena (California, United States), the method identifies 851 individual platforms that range in elevation from 100 to 450 m above sea level. The total platform area is 24.5 km2 over a total area of 394 km2; the majority of platforms are found west of the San Andreas fault. We interpret these platforms as a suite of marine terraces because they are generally elongate parallel to the modern coastline and one another, and their elevations increase systematically from west to east in a step-like fashion. Geologic evidence supporting this conclusion includes locally abundant well-rounded and well-polished clasts with heterogeneous compositions, beveled outcrops of the underlying bedrock (German Rancho Formation), and provenance studies indicating transport of clasts contained in probable marine deposits across the San Andreas fault. The platforms contain 21 different elevation bands, each of which is 2-6 m high, suggesting that they may define a flight of 21 distinct marine terraces at elevations between 113 and 405 m above sea level. Matching the 21 observed platform elevations with those predicted from sealevel curves suggests that the surface uplift rate for the northern coast of California has been ∼0.2 mm/yr over the past 2 Ma. This rate is similar to, but lower than the previously determined uplift rate of ∼0.3 mm/yr for a ∼23 m marine terrace in the area. [ABSTRACT FROM AUTHOR]

Published
2012
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98. Development of mock circulation models for the assessment of counterpulsation systems.

Author

Bowles, Christopher T, Shah, Samir S, Nishimura, Kazunobu, Clark, Colin, Cumming, Deborah V E, Pattison, Charles W, Pepper, John R, and Yacoub, Magdi H

Abstract

Study objective — This study entailed the development of mock circulation models to assess and compare the haemodynamic efficacy of extra-aortic counterpulsation (using trained skeletal muscle wrapped around the proximal descending aorta) and conventional intra-aortic balloon counterpulsation.Design and experimental materials — Hydraulic Windkessel type lumped parameter models were used either in conjunction with native skeletal muscle or as a dynamic simulation of counterpulsation. The haemodynamic performance of the wrapped latissimus dorsi muscle of the normal sheep was assessed using an artificial load to simulate the pressurised proximal descending aorta. Mock circulation models of counterpulsation comprised Windkessel compliance chambers, laminar flow resistors, a blood analogue, a prosthetic blood pump, and a purpose made hydraulic counterpulsator.Measurements and main results — An electrically stimulated muscle wrap, 5 cm in length, previously trained for 2 weeks at 3 V and 35 Hz, was assessed for haemodynamic performance in a mock circulation: volume of fluid displaced = 14.1(SD 1.8) ml; pressure increase from 100 mm Hg = 14.9(2.1) mm Hg; external work per contraction cycle = 180(70) mJ; external mean power = 800(100) mW. In a simulation of intra-aortic balloon counterpulsation, haemodynamic benefit (ie, an increase in proximal flow rate and endocardial viability ratio and a reduction in left ventricular stroke power) was assessed with respect to defined parameters.Conclusions — This paper demonstrates the potential of the mock circulation models both for the investigation of muscle wrap performance and for the comparison of extra-aortic muscle with intra-aortic balloon counterpulsation. [ABSTRACT FROM PUBLISHER]

Published
1991

99. Central extracorporeal life support with left ventricular decompression for the treatment of refractory cardiogenic shock and lung failure

Author

Weymann, Alexander, Schmack, Bastian, Sabashnikov, Anton, Bowles, Christopher T., Raake, Philipp, Arif, Rawa, Verch, Markus, Tochtermann, Ursula, Roggenbach, Jens, Popov, Aron F., Simon, Andre R., Karck, Matthias, and Ruhparwar, Arjang

Subjects
Surgery, Cardiology and Cardiovascular Medicine
Abstract

Background The purpose of this prospective study was to evaluate the effects and functional outcome of central extracorporeal life support (ECLS) with left ventricular decompression for the treatment of refractory cardiogenic shock and lung failure. Methods Between August 2010 and August 2013, 12 consecutive patients (2 female) with a mean age of 31.6 ± 15.1 years received central ECLS with left ventricular decompression for the treatment of refractory cardiogenic shock and lung failure. Underlying disease was acute cardiac decompensation due to dilated cardiomyopathy (n = 3, 25%), coronary artery disease with acute myocardial infarction (AMI) (n = 3, 25%), and acute myocarditis (n = 6, 50%). We routinely implemented ECLS by cannulating the ascending aorta, right atrium and inserting a left ventricular decompression cannula vent via the right superior pulmonary vein. Results All patients were successfully bridged to either recovery (n = 3, 25%), long-term biventricular support (n = 6, 50%) or cardiac transplantation (n = 3, 25%). Seven patients (58.3%) were discharged after a mean hospital stay of 42 ± 11.9 days. The overall survival from ECLS implantation to the end of the study was 58.3%. The cumulative ICU stay was 23.1 ± 9.6 days. The length of support was 8.0 ± 4.3 days (range 3-17 days). Conclusions We strongly recommend left ventricular decompression in refractory cardiogenic shock and lung failure to avoid pulmonary edema, left heart distension and facilitate myocardial recovery. peerReviewed

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100. RECOGNISING A LOST EARLY MEDIEVAL KINGDOM.

Author

Toolis, Ronan and Bowles, Christopher

Abstract

The article reports on the excavations at Trusty's Hill, a Dark Age hill fort in Galloway, Scotland. It mentions the fortification of the hill around the year 600, the antiquities found there that establish that the site was more than just a fort, and the possibility that the fort was part of the lost Pictish kingdom of Rheged.

Published
2017

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