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A pneumatically driven artificial heart with a tubular silicone rubber membrane and disc valves was used for functional heart replacement in the paracorporeal mode. A fluidic drive system allows adjustment of the heart rate, positive and negative pressures and systole/diastole ratio. dextran, 500 ml/day; and aspirin, 4 x 0 5 gm/day)

Objective -To evaluate the Coronary Flow Reserve in the Coronary Sinus through transesophageal Doppler echocardiography in normal subjects. Methods - Study of Coronary Sinus Flow Reserve Through Transesophageal Doppler Echocardiography in Normal SubjectsOriginal ArticleThe capacity to increase coronary blood flow in response to an appropriate stimulus was determined by coronary flow reserve (CFR) or vasodilatating coronary reserve CSF by TEE can be monitored within a distance of 1 to 1.5 cm, from the ostium with adequate alignment between the ultrasound beam and the coronary sinus (CS), where achieving adequate flow would be possible in more than 90% of cases 6 . This method is useful for evaluating coronary flow (CF) in cases of specific lesion in the left anterior descending coronary artery 10 or in situations with alterations in coronary circulation, as well as micro-circulation 9,10

Postoperative echocardiograms of 50 patients undergoing myectomy for hypertrophic obstructive cardiomyopathy between 1965 and 1982 have been evaluated. In 21 patients a comparison with preoperative echocardiograms showed that postoperatively there was a significant reduction of septal and free wall thickness, an increase of left ventricular end-diastolic as well as outflow tract dimensions and a reduction or disappearance of systolic anterior motion of the mitral leaflet. Postoperative examination at intervals greater than 3 years revealed a significant increase of left ventricular and left atrial cavity size with unchanged contractile parameters and little reduction of left ventricular hypertrophy. In 4 of 12 patients evaluated greater than 8 years after myectomy, left ventricular dilatation was observed and 3 of these 4 patients developed congestive heart failure. Development of left ventricular dilatation was independent of whether a transventricular and/or transaortic approach was used for myectomy. These data indicate that the late course after myectomy in hypertrophic obstructive cardiomyopathy may be complicated by dilatation of the left ventricular cavity.

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