Christoph Haller

Universitätsklinikum Tübingen, Tübingen, Baden-Württemberg, Germany

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Publications (20)49.56 Total impact

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    ABSTRACT: The hemocompatible properties of rotary blood pumps commonly used in mechanical circulatory support (MCS) are widely unknown regarding specific biocompatibility profiles of different pump technologies. Therefore, we analyzed the hemocompatibility indicating markers of an axial flow and a magnetically levitated centrifugal device within an in vitro mock loop. The HeartMate II (HM II; n = 3) device and a CentriMag (CM; n = 3) adult pump were investigated in a human whole blood mock loop for 360 min using the MCS devices as a driving component. Blood samples were analyzed by enzyme-linked immunosorbent assay for markers of coagulation, complement system, and inflammatory response. There was a time-dependent activation of the coagulation (thrombin-antithrombin complexes [TAT]), complement (SC5b-9), and inflammation system (polymorphonuclear [PMN] elastase) in both groups. The mean value of TAT (CM: 4.0 μg/L vs. 29.4 μg/L, P < 0.001; HM II: 4.5 μg/L vs. 232.2 μg/L, P < 0.05) and PMN elastase (CM: 53.4 ng/mL vs. 253.8 ng/mL, P < 0.05; HM II: 28.0 ng/mL vs. 738.8 ng/mL, P < 0.001) significantly increased from baseline until the end of the experiments (360 min). After 360 min, TAT and PMN values were significantly higher in the HM II group compared with the values in the CM adult group. The values of SC5b-9 increased from baseline to 360 min in the CM group (CM: 141.8 ng/mL vs. 967.9 ng/mL, P < 0.05) and the HM II group. However, the increase within the HM II group (97.3 vs. 2462.0, P = 0.06) and the comparison of the 360-min values between CM group and HM II group did not reach significance (P = 0.18). The activation of complement, coagulation, and inflammation system showed a time-dependent manner in both devices. The centrifugal CM device showed significantly lower activation of coagulation and inflammation than that of the HM II axial flow pump. Both HM II and CM have demonstrated an acceptable hemocompatibility profile in patients. However, there is a great opportunity to gain a clinical benefit by developing techniques to lower the blood surface interaction within both pump technologies and a magnetically levitated centrifugal pump design might be superior. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals Inc.
    Artificial Organs 08/2015; 39(8):723-8. DOI:10.1111/aor.12544 · 2.05 Impact Factor
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    ABSTRACT: The catheter-based Impella 5.0 left ventricular assist device (LVAD) is a powerful and less invasive alternative for patients in cardiogenic shock. The use of this device as a primary mechanical circulatory support strategy in INTERMACS II patients should be evaluated. From April 2014 to August 2014, eight Impella 5.0 devices were implanted in seven patients via the axillary artery access (six right and two left). We analyzed the outcome of the four patients in whom the Impella 5.0 device was implanted for the purpose of primary stabilization of cardiogenic shock (INTERMACS II). The remaining three patients had a contraindication for a permanent LVAD and received the device for prolonged weaning from extracorporeal life support (ECLS) system. The implantation of the Impella 5.0 was technically successful in all patients and resulted in the stabilization of the clinical situation. All four patients could be bridged to a long-term device (n = 3) or to cardiac recovery (n = 1). In one patient, 2 days of ECLS support was necessary because of pump thrombosis after 31 days of Impella 5.0 support. One patient with bronchopneumonia had the Impella 5.0 exchanged from the right to the left axillary artery after 22 days of support because of the progressive loss of purge flow and the need for longer bridging to a permanent LVAD. The last patient was supported for giant-cell myocarditis for 22 days and bridged to cardiac recovery. All patients were transferred to the intensive care unit with the Impella device in place. In INTERMACS II situations, the implantation of the Impella 5.0 via the right or left axillary access allowed additional time for decision making. Early patient mobilization, including walking with the Impella device in place, optimized the conditions for either weaning or the implantation of a permanent LVAD. This novel technique of left axillary approach leads to more flexibility in the case of anatomical- or device-related contraindications to right-side access, or when the device needs to be exchanged while continuous support is necessary. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.
    Artificial Organs 07/2015; 39(8). DOI:10.1111/aor.12529 · 2.05 Impact Factor
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    ABSTRACT: We herein present a new surgical technique in the treatment of an anomalous left coronary artery from the right coronary sinus in an 18-year-old patient with an intramural course of the left main coronary artery. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
    The Annals of thoracic surgery 06/2015; 99(6):2234-2236. DOI:10.1016/j.athoracsur.2015.01.069 · 3.85 Impact Factor

  • Circulation 03/2015; 131(10):925-6. DOI:10.1161/CIRCULATIONAHA.114.013069 · 14.43 Impact Factor

  • The Thoracic and Cardiovascular Surgeon 01/2015; 63(S 01). DOI:10.1055/s-0035-1544296 · 0.98 Impact Factor
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    ABSTRACT: A multitude of stem cell types has been extensively studied and used for myocardial regenerative therapy. Amongst these endothelial progenitor cells form a promising source. In our present study, we investigated a one-staged approach for isolation and application of autologous endothelial progenitor cells in a pig model of myocardial infarction. Endothelial progenitor cell isolation was performed by immediately preprocedural bone marrow aspiration and consecutive positive selection by aptamer-based magnetic cell sorting. Animals were divided in three groups receiving endothelial progenitor cells, saline, or no intramyocardial injection respectively. Postprocedural follow-up consisted of weekly echocardiographic evaluations. Postmortem histological analysis after four weeks focused on detection of transplanted PKH26-positive endothelial progenitor cells and neovascularization within the infarcted myocardium. A significant difference in left ventricular ejection fraction could not be shown between the three groups. PKH26-stained endothelial progenitor cells could be found in the endothelial progenitor cells transplanted group, although detection was scarce. Large-sized capillaries were found to be significantly more in endothelial progenitor cells treated myocardium. The one-stage approach of endothelial progenitor cells isolation and application presented herein offers a new therapeutic concept. Even though a beneficial impact on myocardial function could not be assessed, increased neovascularization may indicate positive effects on remodeling processes. Being able to harvest endothelial progenitor cells right before application provides a wider scope of action in urgent cases.
    Nucleic Acid Therapeutics 12/2014; 25(1). DOI:10.1089/nat.2014.0499 · 2.93 Impact Factor

  • The Thoracic and Cardiovascular Surgeon 09/2014; 62(S 02). DOI:10.1055/s-0034-1394066 · 0.98 Impact Factor
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    ABSTRACT: Enterococci are among the major pathogens implicated in cardiac infections and biofilm formation. E. faecalis has been shown to play an important role in infectious endocarditis. Several distinct mechanisms for biofilm formation have been identified in E. faecalis. Our group has previously characterized two distinct bacterial glucosyltransferases playing key roles in the production of the major cell wall glycolipids and leading to reduced biofilm production. To assess if this mechanism is involved in the pathogenesis of enterococcal endocarditis we compared the wild-type strain of E. faecalis 12030 with two mutants in gene EF2891 and EF2890 respectively in a rat model of infective endocarditis. The results showed less endocarditic lesions and reduced colony counts per vegetation in the two mutants. indicating that the modification of bacterial surface lipids results in significantly reduced virulence in infective endocarditis. These results underscore the important role of biofilm formation in the pathogenicity of enterococcal endocarditis and may indicate an interesting target for novel therapeutic strategies.
    PLoS ONE 03/2014; 9(3):e91863. DOI:10.1371/journal.pone.0091863 · 3.23 Impact Factor

  • The Thoracic and Cardiovascular Surgeon 02/2014; 62(S 01). DOI:10.1055/s-0034-1367419 · 0.98 Impact Factor

  • The Thoracic and Cardiovascular Surgeon 02/2014; 62(S 01). DOI:10.1055/s-0034-1367246 · 0.98 Impact Factor
  • G Wiegand · J Leon-Wyss · C Haller · C Schlensak · M Hofbeck ·
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    ABSTRACT: Purpose: The morphologic spectrum of aortic coarctation extends from discrete isthmic obstruction to tubular hypoplasia of the entire aortic arch. Neonates with coarctation frequently present with congestive heart failure and critically reduced perfusion of the descending aorta following ductal closure. During the recent years we observed several infants with coarctation who presented beyond the neonatal period with dilated cardiomyopathy (DCM). We reviewed our patients with coarctation to determine whether this presentation represents an exception or is relevant for the differential diagnosis of children with DCM. Materials and Methods: From 1/2001 to 12/2013 74 babies with isolated coarctation were diagnosed in our institution. 50 patients presented in the neonatal period and 24 patients beyond the first month. Results: 5/74 infants presented after the neonatal period with poorly contractile, dilated left ventricles. Echocardiographic detection of the coarctation was facilitated by application of the ductal view and by Doppler interrogation of the celiac artery revealing a significantly diminished systolic flow velocity. All patients underwent resection of the coarctation and end-to-end anastomosis of the aorta. Postoperative normalization of left ventricular function was observed within a median interval of 2 months. Conclusion: Coarctation of the aorta presenting as DCM accounted for 21 % of our infants with coarctation who presented beyond the neonatal period and 7 % of those in the first year of life. The stenosis was difficult to detect because of its distal location and normal configuration of the aortic arch. Isthmic coarctation should be included in the differential diagnosis of infants with DCM and requires careful examination of the isthmic region in these children. © Georg Thieme Verlag KG Stuttgart · New York.
    Ultraschall in der Medizin 10/2013; 34(S 01). DOI:10.1055/s-0033-1354895 · 4.92 Impact Factor
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    ABSTRACT: In this protocol we provide a method to isolate dendritic cells (DC) and epithelial cells (TEC) from the human thymus. DC and TEC are the major antigen presenting cell (APC) types found in a normal thymus and it is well established that they play distinct roles during thymic selection. These cells are localized in distinct microenvironments in the thymus and each APC type makes up only a minor population of cells. To further understand the biology of these cell types, characterization of these cell populations is highly desirable but due to their low frequency, isolation of any of these cell types requires an efficient and reproducible procedure. This protocol details a method to obtain cells suitable for characterization of diverse cellular properties. Thymic tissue is mechanically disrupted and after different steps of enzymatic digestion, the resulting cell suspension is enriched using a Percoll density centrifugation step. For isolation of myeloid DC (CD11c(+)), cells from the low-density fraction (LDF) are immunoselected by magnetic cell sorting. Enrichment of TEC populations (mTEC, cTEC) is achieved by depletion of hematopoietic (CD45(hi)) cells from the low-density Percoll cell fraction allowing their subsequent isolation via fluorescence activated cell sorting (FACS) using specific cell markers. The isolated cells can be used for different downstream applications.
    Journal of Visualized Experiments 10/2013; DOI:10.3791/50951 · 1.33 Impact Factor
  • C. Haller · T. Krueger · D. Schibilsky · J. Kobba · C. Schlensak ·

    Interactive Cardiovascular and Thoracic Surgery 09/2013; 17(suppl 2):S107-S107. DOI:10.1093/icvts/ivt372.156 · 1.16 Impact Factor
  • D. Schibilsky · C. Haller · T. Kruger · T. Walker · C. Schlensak ·

    Interactive Cardiovascular and Thoracic Surgery 09/2013; 17(suppl 2):S140-S140. DOI:10.1093/icvts/ivt372.291 · 1.16 Impact Factor
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    ABSTRACT: Background: Cold Ischemia-Reperfusion Injury (CIRI) is regarded as the major cause of early graft dysfunction after cardiac transplantations and is associated with rejection episodes. Consequently, it is one of the main therapeutic targets in order to improve survival after heart transplantation. The aim of this study was to evaluate hemodynamic effects of milrinone and its influence on the markers of myocardial damage when used in a piglet working heart model with a cold ischemia-reperfusion setting. Methods: Hearts of 18 piglets were examined in a homologous blood-perfused, working heart model to get baseline measurements. After hypothermic cardioplegic arrest and storage on ice for 60 minutes, the hearts received either milrinone or served as controls. All hearts were examined for 45 minutes in the working heart model. Hemodynamic parameter changes, h-FABP levels and myocardial oxygen consumption were assessed. Results: Significant difference between the groups was observed in cardiac output (MIL +14% vs. CON -33%; p<0.05), coronary sinus blood flow (MIL +84% vs. CON +17%; p<0.05) and relaxation (MIL +5% vs. CON -22%; p<0.01). In addition, significantly higher h-FABP (heart fatty acid binding proteine) levels after cold ischemia were measured in CON group (CON: 18.75 ng/ml; MIL 6.29 ng/ml; p<0.01). Conclusions: Milrinone has a positive effect on cardiac function after cardioplegic cardiac arrest with following cold-ischemia period in an isolated piglet heart model. Its use in a heart transplantation setting induces an improved hemodynamic performance and a better preservation from reperfusion injury.
  • D Schibilsky · C Haller · T Krueger · HP Wendel · T Walker · C Schlensak ·

    The Thoracic and Cardiovascular Surgeon 01/2013; 61(S 01). DOI:10.1055/s-0032-1332340 · 0.98 Impact Factor
  • C Haller · D Schibilsky · M Siepe · C Schlensak ·

    The Thoracic and Cardiovascular Surgeon 02/2012; 60(S 01). DOI:10.1055/s-0031-1297896 · 0.98 Impact Factor
  • C Haller · M Berthold · D Wobser · A Kropec · C Schlensak · J Hübner ·

    The Thoracic and Cardiovascular Surgeon 02/2012; 60(S 01). DOI:10.1055/s-0031-1297519 · 0.98 Impact Factor
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    ABSTRACT: A driveline exit site infection is a serious and common complication in long-term left ventricular assist device (LVAD) support. To reduce the incidence and severity of late driveline infections, we modified our surgical technique (double tunnel), and compared it to the conventional short and straight driveline tunnel technique (conventional). We analyzed 43 consecutive patients (37 HeartMate II; 6 Ventrassist) regarding late onset driveline exit site infections after using the surgical driveline tunnel technique after successful LVAD implantation. Of these 43 patients, 11 were treated with the conventional short and straight driveline tunnel technique (conventional), while 32 patients were treated with the modified long subfascial, C-shaped technique (double tunnel). We observed slightly fewer superficial driveline exit site infections in the double tunnel group, even though the difference was not statistically significant (0.638 vs. 1.148 infections/1,000 patient-days; P = 0.22). There were also insignificantly fewer surgical interventions because of exit site infections in the double tunnel group (0.159 vs. 0.581 revisions/1,000 patient-days; P = 0.18). The double tunnel technique offers more surgical options in the case of driveline exit site infections. Due to the long subfascial tunnel, the infected site can be separated from the new driveline exit site, and vacuum-assisted closure therapy can be applied to the infected area. In conclusion, we recommend using the double tunnel driveline technique because of the low infection rate and better treatment options in the case of driveline exit site infection.
    Journal of Artificial Organs 10/2011; 15(1):44-8. DOI:10.1007/s10047-011-0607-3 · 1.44 Impact Factor
  • Christoph Haller · Koppany Sarai · Matthias Siepe · Friedhelm Beyersdorf ·

    The Journal of thoracic and cardiovascular surgery 11/2010; 140(5):e75-6. DOI:10.1016/j.jtcvs.2010.06.029 · 4.17 Impact Factor

Publication Stats

18 Citations
49.56 Total Impact Points


  • 2014-2015
    • Universitätsklinikum Tübingen
      • Department of Thoracic and Cardiovascular Surgery
      Tübingen, Baden-Württemberg, Germany
  • 2013-2015
    • University of Tuebingen
      • Department of Thoracic and Cardiovascular Surgery
      Tübingen, Baden-Württemberg, Germany
  • 2010-2011
    • Universitätsklinikum Freiburg
      • Department of Radiology and Radiotherapy
      Freiburg an der Elbe, Lower Saxony, Germany