Avec le concours de candidats g~ une revascularisation coronarienne, nous avons mesurg l'effet de l'utilisation de bloqueurs des r~cepteurs histaminiques H t et 1-12 avant l' injection de protamine, sur la r~ponse hdmodynamique d cette derni&e. Les patients du Groupe 1 ne recevaient aucun pr~-traitement rnais nous injections prophylactiquement de la dyphenhydramine (anti-Hi) et de la cim~tidine (anti-H2) d ceux du Groupe H. Les moyennes des pressions art~rielles systoliques, diastoliques, des tensions veineuses centrales et du pouls avant (et aprds) r injection de protamine ~taient respectivement dans le 64 • 11 (51 • 8), 81 • 11 (65 • 10), 10 • 3 (11 + 7) mmHg et de 92 ++-10 (87 +-13) battements. min -t .Dans le Groupe 11, ces m~mes moyennes ~taient de: 113 +_ 19(113 + -17), 61 • 12(61 • 11), 79• 15(80• 13),9• 3 (9 + 2) mmHg et de 88 +-6 (86 +--4) Protamine, a highly alkaline compound, is used routinely to reverse the anticoagulation effect induced by heparin. Protamine administration is associated with adverse haemodynamic responses including acute anaphylaxis. I-3 Prophylactic treatment with histamine1 (H1) and hista-

Premarin was administered prophylactically to every other patient in a series of 148 consecutive cases of open intracardiac surgery. Of these, 132 patients were matched to analyse the results of Premarin administration and postoperative blood loss. There were 67 patients who were given Premarin and 65 who did not receive this drug; both groups were identical in respect of age and sex. Matching was undertaken according to history of previous cardiac operations and anticoagulation, type of valve surgery or repair of congenital anomaly, duration of perfusion, platelet count and the use of fresh blood and epsilon-aminocaproic acid in the postoperative period. The prophylactic use of Premarin was not associated with a reduction in postoperative bleeding.

Surgical treatment in 8 cases of non-tropical eosinophilic endomyocardial diseases with (4 patients) and without (4 patients) eosinophilia is reported. Follow-up results (1 to 4 years) in the 6 survivors, including hemodynamic re-study, were excellent even in patients operated on in the thrombotic stage (3) or with hypereosinophilia (2), or with dominant right ventricular involvement (3). Two-dimensional echocardiography gave the correct description of the pathologic stage and ventricular involvement in 6 of the 8 cases before catheterization.

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