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Cialix and the question was does LV unloading start to affect ischemia before reperfusion and in fact are we having an ischemic effect now right in the same time the ichikawa lab from New York was starting to show that with these unloading pumps they were seeing enhanced coronary flow through the myocardium even though the artery was blocked or if the patient had or if the animal had a scar from an infarct we took some of these concepts and started to test this in our laboratory and what we found was that with unloading on the right there was an increase in microsurgical Ettore coronary flow and in fact this started to shrink the area of risk so if you were to open that blocked artery and 50% of the Ariat risk is infarcted no matter what you do another potential mechanism is that by reducing Cialix Male Enhancement getting more cardio protection so we took these preclinical ease clinical data and went back to the bench area at risk you're already going to see a reducti