EXHIBIT 10.46

	  515 Penn Street
	  PO Box 141
	  Reading PA 19603
	  610 655 8109
	  Fax 610 655 8208

	  Philip B Shober
	  Vice President
	
                                         								CORESTATES
					                                         			HAMILTON BANK

AMH (Arrow Medical Holdings) B.V.                               
c/o Arrow International, Inc.
P. 0. Box 12888
Reading, PA 19612

Attn.:  Mr. John Broadbent, Jr.
	Vice President - Finance

Dear John:

I am very pleased to advise you that CoreStates Bank, N.A. ("Bank") has 
approved an unsecured bullet loan to AMH (Arrow Medical Holdings) 
B.V. ("Borrower") as follows:

	Principal Amount of Loan        20 Million Dutch Guilders

	Interest Rate                   Adjusted LIBOR plus .75%, or        
                            					a fixed rate as quoted

	Repayment Schedule              Interest quarterly or at the 
                            					expiration of an interest       
				                            	rate period (whichever is 
				                            	sooner); principal due at       
				                            	maturity on July 31, 2001 

	Use of Proceeds                 Refinance construction of 
                            					plant in Czech Republic

This loan shall have the corporate suretyship of Arrow International, Inc. 
("Guarantor").  The Borrower is a wholly-owned subsidiary of the 
Guarantor.  The form of suretyship ("Guaranty") shall contain a 
confession of judgment clause.

The conditions applicable to this credit facility are as follows:

	A.      The ratio of the Guarantor's "total liabilities" to "tangible 
		net worth" shall not exceed 1.50 to 1 (tested quarterly).

	B.      The ratio of the Guarantor's "cash flow" to "debt service" 
		shall meet or exceed 1.25 to 1, tested annually based on        
		the consolidated audited financial statement. ("Cash flow" 
		defined as Net Income plus Depreciation, plus           
		Amortization, minus Dividends, minus Capital            
		Expenditures not funded by Bank financing or equity


AMH (Arrow Medical Holdings) B.V.
c/o Arrow International, Inc.
Page Two

		injection, plus interest.  "Debt Service" defined as 
		scheduled principal payments on long term debt during the 
		year, plus interest.)

	 C.     "All General Conditions" as described in the Letter 
		Agreement dated February 25, 1993 between the Bank and 
		the Guarantor shall also apply hereto.  These General 
		Conditions are restated below.

		a.      Receipt of annual consolidated audited financial 
			statement of the Guarantor prepared by an 
			independent accounting firm acceptable to the 
			Bank, within 120 days after the close of the fiscal 
			year

		b.      Receipt of quarterly company-prepared financial 
			statements of the Guarantor.

		c.      All of the credit facilities now or hereafter 
			outstanding between the Bank, Borrower, 
			Guarantor, or any of the Guarantor's wholly-owned 
			subsidiaries shall be cross-defaulted, such that a 
			default under any of the credit facilities shall, 
			without more, constitute a default under all of the 
			credit facilities.

		d.      The Guarantor will not merge into, or consolidate 
			with, one or more corporations where the 
			Guarantor is not the surviving corporation, or be a 
			party to any transaction involving the transfer, or 
			pledging as collateral, of any material portion of its 
			assets, revenues, or properties to or with any lender 
			or other Creditor, or any other corporation or other 
			Person, or resulting in any material change of 
			control of the Guarantor, without the prior written 
			consent of the Bank.

		e.      Any change in the senior management personnel of 
			the Guarantor must be promptly disclosed in 
			writing to the Bank.

	 D.      All other terms and conditions as outlined in the 
		 Commercial Promissory Note and Addendum thereto of 
		 even date herewith, the terms of which are incorporated 
		 herein by reference.

All costs incurred by the Bank on connection with the extension and/or 
establishment of the credit facilities as outlined above, including but not 
limited to the reasonable fees of Bank's legal counsel shall be paid by the 
Borrower.

The Borrower has not breached and is not in violation of any 
environmental protection law, rule, or regulation.  The Borrower further 
agrees to notify the Bank in writing immediately of any such breach or 
violation.



AMH (Arrow Medical Holdings) B.V.
c/o Arrow International, Inc.
Page Three


The availability of the foregoing is also contingent upon the execution and 
delivery to the Bank of such other loan documentation, including 
commercial loan notes, corporate borrowing resolutions, and other 
documentation ("Related Documentation") as may be required by the 
Bank.  The terms and conditions of this Letter shall survive the execution 
and/or delivery of any other documentation and shall remain in full force 
and effect until all obligations of the Borrower to the Bank are performed 
and paid in full.  Any failure by the Borrower and/or the Guarantor to 
fulfill and perform any of their obligations to the Bank hereunder or 
under the credit facilities provided or extended herein shall be deemed a 
default hereunder, under all other obligations of the Borrower and/or the 
Guarantor, and under any related documentation.  Any default under or 
pursuant to any other obligations of the Borrower and/or the Guarantor or 
under any related documentation shall be deemed a default hereunder and 
under the credit facilities provided or extended herein.

Please acknowledge your concurrence with these terms and conditions by 
signing, dating and returning the enclosed copy of this letter to the Bank.

Sincerely,



Philip B. Shober
Vice President

PBS/pl

July 11, 1996

Enclosures

ACKNOWLEDGMENT PAGE FOLLOWS.



AMH (Arrow Medical Holdings) B.V.
c/o Arrow International, Inc.
Page Four



			       ACKNOWLEDGMENT
			       --------------

			  The terms and conditions outlined in this letter 
			  are hereby accepted and agreed to, intending to be 
			  legally bound this 17th day of July, 1996.

			  AMH (ARROW MEDICAL HOLDINGS) B.V.

			  By:     /s/Marlin Miller, Jr.   
				  -------------------------------------
				  Marlin Miller, Jr., Managing Director

			  By:     /s/John Broadbent, Jr.       
				  --------------------------------------
				  John Broadbent, Jr., Managing Director



			  GUARANTOR:      

			  ARROW INTERNATIONAL, INC.


			  By:     /s/Marlin Miller, Jr.   
				  -------------------------------------
				  Marlin Miller, Jr., Managing Director

			  By:     /s/John Broadbent, Jr.       
				  --------------------------------------
				  John Broadbent, Jr., Managing Director




For Bank Use Only




			  COMMERCIAL PROMISSORY NOTE
								CORESTATES

$20,000,000 Guilder                                             July 17, 1996
- -------------------                                             -------------
	FOR VALUE RECEIVED, each of the undersigned, jointly and 
severally if more than one (hereinafter collectively referred to as 
"Borrower"), promises to pay to the order of CORESTATES BANK, 
N.A.*, a national banking association (the "Bank"), organized under the 
laws of the United States of America, through its offices in London and 
in the manner and place set forth in the attached Addendum to 
Commercial Promissory Note, the terms of which are incorporated herein 
and shall be controlling, the principal sum of Twenty Million Guilder, 
currently of The Netherlands, plus interest, as set forth in the Addendum.


ADDITIONAL TERMS OF THIS NOTE - EACH OF THE FOLLOWING 
PROVISIONS SHALL APPLY TO THIS NOTE, TO ANY EXTENSION OR MODIFICATION 
HEREOF AND TO THE INDEBTEDNESS EVIDENCED HEREBY, EXCEPT AS OTHERWISE 
EXPRESSLY STATED ABOVE OR IN A SEPARATE WRITING SIGNED BY BANK AND 
BORROWER.

INTEREST - Interest shall be calculated on the basis of a 360-day year 
and shall be charged for the actual number of days elapsed.  Accrued 
interest shall be payable monthly.  Accrued interest shall also be payable 
when the entire principal balance of this Note becomes due and payable 
(whether by demand, stated maturity or acceleration) or, if earlier, when 
such principal balance is actually paid to Bank.  If the rate at which 
interest accrues is based on the "Prime Rate", that term is defined as the 
rate of interest for loans established by Bank from time to time as its 
prime rate.  Said per annum rate of interest shall change each time Bank's 
prime rate shall change, effective on and as of the date of the change.  
Interest shall accrue on each disbursement hereunder from the date such 
disbursement is made by Bank, provided, however, that to the extent this 
Note represents a replacement, substitution, renewal or refinancing of 
existing indebtedness, interest shall accrue from the date hereof.  Interest 
shall accrue on the unpaid balance hereof at the rate provided for in this 
Note until the entire unpaid balance has been paid in full, notwithstanding 
the entry of any judgment against Borrower.

PREPAYMENT - If this Note bears interest at a floating or variable rate 
and no floor or minimum rate is specified, Borrower may prepay all or 
any portion of the principal balance of this Note at any time, without 
premium or penalty. If not permitted under the preceding sentence. any 
prepayment of principal (including any principal repayment as a result of 
acceleration by Bank of this Note) shall require immediate payment to 
Bank of a prepayment fee equal to the amount, if any, by which the 
aggregate present value of scheduled principal and interest payments 
eliminated by the prepayment exceeds the principal amount being 
prepaid.  Said present value shall be calculated by application of a 
discount rate determined by Bank in its reasonable judgment to be the 
yield-to-maturity at the time of prepayment on U.S. Treasury securities 
having a maturity which most closely approximates the final maturity date 
of the principal balance then outstanding.  Whether or not a prepayment 
fee is required hereunder, prepayments shall be applied to scheduled 
installments of principal in the inverse order of their maturity, shall be 
accompanied by payment of accrued interest on the principal amount 
being prepaid and, unless this Note has been accelerated by Bank, shall 
not be permitted in an amount less than the scheduled principal 
installment immediately prior to final maturity of the outstanding 
principal balance.

COLLATERAL - As security for all indebtedness to Bank now or 
hereafter incurred by Borrower, under this Note or otherwise, Borrower 
grants Bank a lien upon and security interest in any securities, 
instruments or other personal property of Borrower now or hereafter in 
Bank's possession and in any deposit balances now or hereafter held by 
Bank for Borrower's account, and in all proceeds of any such personal 
property or deposit balances.  Such liens and security interest shall be 
independent of Bank's right of setoff.  This Note and the indebtedness 
evidenced hereby shall be additionally secured by any lien or security 
interest evidenced by a writing (whether now existing or hereafter 
executed) which contains a provision to the effect that such lien or 
security interest is intended to secure (a) this Note or indebtedness 
evidenced hereby or (b) any category of liabilities, obligations or 
indebtedness of Borrower to Bank which includes this Note or the 
indebtedness evidenced hereby, and all property subject to any such lien 
or security interest shall be collateral for this Note.

EVENTS OF DEFAULT - Each of the following shall be an Event of 
Default hereunder: (a) the nonpayment when due of any amount payable 
under this Note or under any obligation or indebtedness to Bank of 
Borrower or any person liable, either absolutely or contingently, for 
payment of any indebtedness evidenced hereby, including endorsers, 
guarantors and sureties (each such person is referred to as an "Obligor"); 
(b) if Borrower or any Obligor has failed to observe or perform any other 
existing or future agreement with Bank of any nature whatsoever; (c) if 
any representation, warranty, certificate, financial statement or other 
information made or given by Borrower or any Obligor to Bank is 
materially incorrect or misleading; (d) if Borrower or any Obligor shall 
become insolvent or make an assignment for the benefit of creditors or if 
any petition shall be filed by or against Borrower or any Obligor under 
any bankruptcy or insolvency law; (e) the entry of any judgment against 
Borrower or any Obligor which remains unsatisfied for 15 days or the 
issuance of any attachment, tax lien, levy or garnishment against any 
property of material value in which Borrower or any Obligor has an 
interest; (f) if any attachment, levy, garnishment or similar legal process 
is served upon Bank as a result of any claim against Borrower or any 
Obligor or against any property of Borrower or any Obligor; (g) the 
dissolution, merger, consolidation or change in control (as control is 
defined in Rule 12b-2 Under the Securities Exchange Act of 1934), of 
any Borrower which is a corporation or partnership, or the sale or 
transfer of any substantial portion of any of Borrower's assets, or if any 
agreement for such dissolution, merger, or consolidation, change in 
control, sale or transfer is entered into by Borrower, without the written 
consent of Bank; (h) the death of any Borrower or Obligor who is a 
natural person; (i) if Bank determines reasonably and in good faith that an 
event has occurred or a condition exists which has had, or is likely to 
have, a material adverse effect on the financial condition or 
creditworthiness of Borrower or any Obligor, or on the ability of 
Borrower or any Obligor to perform its obligation evidenced by this 
Note; (j) if Borrower shall fail to remit promptly when due to the 
appropriate government agency or authorized depository, any amount 
collected or withheld from any employee of Borrower for payroll taxes, 
Social Security payments or similar payroll deductions; (k) if any Obligor 
shall attempt to terminate or disclaim such Obligor's liability for the 
indebtedness evidenced by this Note; (l) if Bank shall reasonably and in 
good faith determine and notify Borrower that any collateral for this Note 
or for the indebtedness evidenced hereby is insufficient as to quality or 
quantity; (m) if Borrower shall fail to pay when due any material 
indebtedness for borrowed money other than to Bank; or (n) if Borrower 
shall be notified of the failure of Borrower or any Obligor to provide 
financial and other information promptly when reasonably requested by 
Bank.  IF THIS NOTE IS PAYABLE ON DEMAND, Bank's right to demand 
payment hereof shall not be restricted or impaired by the absence, 
non-occurrence or waiver of an Event of Default, and it is understood that 
if this Note is payable on demand, Bank may demand payment at any 
time.
- ------------------------------------------------------------------------
* CoreStates Bank,  N.A. also conducts business as Philadelphia National 
Bank, as CoreStates First Pennsylvania Bank and as CoreStates Hamilton 
Bank
8979-C 10/93

BANK'S REMEDIES - Upon the occurrence of one or more Events of 
Default (including, if this Note is payable on demand, any Event of 
Default resulting from Borrower's failure to make any payment hereunder 
when demanded), unless Bank elects otherwise, the entire unpaid balance 
of this Note and all accrued interest shall be immediately due and payable 
without notice to Borrower or any Obligor, and Bank may, immediately 
or at any time thereafter, exercise any or all of its rights and remedies 
hereunder or under any agreement or otherwise under applicable law 
against Borrower, any Obligor and any collateral.  Bank may exercise its 
rights and remedies in any order and may, at its option, delay in or 
refrain from exercising some or all of its rights and remedies without 
prejudice thereto.  Upon the occurrence of any such Event of Default or 
at any time thereafter, Bank may, at its option, and upon five days 
written notice to Borrower, begin accruing interest on this Note, at a rate 
not to exceed five percent (5%) per annum in excess of the greater of (a) 
the rate of interest provided for above, or (b) the Prime Rate in effect 
from time to time on the unpaid principal balance hereof; provided, 
however, that no interest shall accrue hereunder in excess of the 
maximum rate permitted by law.  All such additional interest shall be 
payable on demand.

NOTICE TO BORROWER - Any notice required to be given by Bank 
under the provisions of this Note shall be effective as to each Borrower 
and each Obligor when addressed to Borrower and deposited in the mail 
postage prepaid, for delivery by first class mail at Borrower's mailing 
address as it appears on Bank's record.

DISBURSEMENTS AND PAYMENTS - The proceeds of this Note, or 
any portion thereof, may be credited by Bank to the deposit account of 
Borrower, or disbursed in any other manner requested by Borrower and 
approved by Bank.  If Borrower so requests, Bank may, at its option, 
disburse the proceeds of this Note in more than one disbursement on the 
same or different dates, but except as otherwise agreed by Bank in 
writing, no action taken by Bank in response to any such request shall be 
deemed to create or shall imply the existence of any commitment or 
obligation to pay or credit the undisbursed portion of this Note.  All 
payments due under this Note are to be made in immediately available 
funds.  If Bank accepts payment in any other form, such payment shall 
not be deemed to have been made until the funds comprising such 
payment have actually been received by or made available to Bank.  If 
Borrower is not an individual, Borrower authorizes Bank (but Bank shall 
have no obligation) to charge any deposit account in Borrower's name for 
any and all payments of principal or any other amounts due under this 
Note.

PAYMENT OF COSTS - In addition to the principal and interest payable 
hereunder,  Borrower agrees to pay Bank, on demand, all costs and 
expenses (including reasonable attorneys' fees and disbursements) which 
may be incurred by Bank in the collection of this Note or the enforcement 
of Bank's rights and remedies hereunder.

REPRESENTATIONS BY BORROWER - If Borrower is a corporation 
or a general or limited partnership, Borrower represents and warrants that 
it is validly existing and in good standing in the jurisdiction under whose 
laws it was organized.  If Borrower is a corporation, Borrower represents 
and warrants that the execution, delivery and performance of this Note 
are within Borrower's corporate powers, have been duly authorized by all 
necessary action by Borrower's Board of Directors, and are not in 
contravention of the terms of Borrower's charter, by-laws, or any 
resolution of its Board of Directors.  If Borrower is a general or limited 
partnership, Borrower represents and warrants that the execution, 
delivery and performance of this Note have been duly authorized and are 
not in conflict with any provision of Borrower's partnership agreement or 
certificate of limited partnership.  Borrower further represents and 
warrants that this Note has been validly executed and is enforceable in 
accordance with its terms, that the execution, delivery and performance 
by Borrower of this Note are not in contravention of law and do not 
conflict with any indenture, agreement or undertaking to which Borrower 
is a party or is otherwise bound, and that no consent or approval of any 
governmental authority or any third party is required in connection with 
the execution, delivery and performance of this Note. 

WAIVER, ETC. - Borrower and each Obligor waive presentment, 
dishonor, notice of dishonor, protest and notice of protest.  Neither the 
failure nor any delay on the part of Bank to exercise any right, remedy, 
power or privilege hereunder shall operate as a waiver or modification
thereof.  No consent, waiver or modification of the terms of this 
Note shall be effective unless set forth in a writing signed by Bank.  
All rights and remedies of Bank are cumulative and concurrent and no single 
or partial exercise of any power or privilege shall preclude any other or 
further exercise of any right, power or privilege. 

MISCELLANEOUS - This Note is the unconditional obligation of 
Borrower and Borrower agrees that Bank shall not be required to exercise 
any of its rights or remedies against any collateral in which it holds a lien 
or security interest or against which it has a right of setoff or against any 
particular Obligor.  All representations, warranties and agreements herein 
are made jointly and severally by each Borrower.  If any provision of this 
Note shall be held invalid or unenforceable, such invalidity or 
unenforceability shall not affect any other provision hereof.  To the extent 
that this Note represents a replacement, substitution, renewal or 
refinancing of a pre-existing note or other evidence of indebtedness, the 
indebtedness represented by such pre-existing note or other instrument 
shall not be deemed to have been extinguished hereby.  In the event that 
any due date specified or otherwise provided for in this Note shall fall on 
a day on which Bank is not open for business, such due date shall be 
postponed until the next banking day, and interest and any fees or similar 
charges shall continue to accrue during period of postponement.  This 
Note has been delivered in and shall be governed by and construed in 
accordance with the laws of the Commonwealth of Pennsylvania without 
regard to the law of conflicts.  This Note shall be binding upon each 
Borrower and each Obligor and upon their personal representatives, 
heirs, successors and assigns, and shall benefit Bank and its successors 
and assigns.

CONSENT TO JURISDICTION AND VENUE - IN ANY LEGAL 
PROCEEDING INVOLVING, DIRECTLY OR INDIRECTLY, ANY 
MATTER ARISING OUT OF OR RELATED TO THIS NOTE OR THE 
RELATIONSHIP EVIDENCED HEREBY.  EACH UNDERSIGNED 
PARTY HEREBY IRREVOCABLY SUBMITS TO THE 
NONEXCLUSIVE JURISDICTION OF ANY STATE OR FEDERAL 
COURT LOCATED IN ANY COUNTY OF THE COMMONWEALTH 
OF PENNSYLVANIA WHERE BANK MAINTAINS AN OFFICE 
AND AGREES NOT TO RAISE ANY OBJECTION TO SUCH 
JURISDICTION OR TO THE LAYING OR MAINTAINING OF THE 
VENUE OF ANY SUCH PROCEEDING IN SUCH COUNTY.  EACH 
UNDERSIGNED PARTY AGREES THAT SERVICE OF PROCESS IN 
ANY SUCH PROCEEDING, MAY BE DULY EFFECTED UPON IT 
BY MAILING A COPY THEREOF, BY REGISTERED MAIL, 
POSTAGE PREPAID, TO EACH UNDERSIGNED PARTY.

WAIVER OF JURY TRIAL - EACH UNDERSIGNED PARTY 
HEREBY WAIVES, AND BANK BY ITS ACCEPTANCE HEREOF 
THEREBY WAIVES, TRIAL BY JURY IN ANY LEGAL 
PROCEEDING INVOLVING, DIRECTLY OR INDIRECTLY, ANY 
MATTER (WHETHER SOUNDING IN TORT, CONTRACT OR 
OTHERWISE) IN ANY WAY ARISING OUT OF OR RELATED TO 
THIS NOTE OR THE RELATIONSHIP EVIDENCED HEREBY.
THIS PROVISION IS A MATERIAL INDUCEMENT FOR BANK TO 
ENTER INTO, ACCEPT OR RELY UPON THIS NOTE.

IN WITNESS WHEREOF, Borrower, intending this to be a sealed 
instrument and intending to be legally bound hereby, has executed and 
delivered this Note as of the day and year first above written.

- -------------------------------------------------------------------------
Name of Corporation
or Partnership                 AMH (Arrow Medical Holdings) B.V.


By:   /s/Marlin Miller, Jr.             By:  /s/John Broadbent, Jr.       
      --------------------------------       --------------------------------
      (Signature of Authorized Signer)       (Signature of Authorized Signer)

Marlin Miller, Jr., Managing Director   John Broadbent, Jr., Managing Director

(Print or Type Name and Title of Signer Above)  
                           				(Print or Type Name and Title of Signer Above)

INDIVIDUALS SIGN BELOW

- ----------------------                  --------------------------- (Seal)
(Signature of Witness)                  (Signature of Individual Borrower)


- -------------------------------------    ------------------------------  
(Print or Type Name of Above Witness) 
                           				(Print or Type Name of Borrower Signing Above)


- ----------------------                   -------------------------- (Seal)
(Signature of Witness)                  (Signature of Individual Borrower)


- -------------------------------------    ------------------------------     
(Print or Type Name of Above Witness)           
                           				(Print or Type Name of Borrower Signing Above)



                        				   GUARANTY

CORESTATES

	This Guaranty is made and entered into by the undersigned, and 
by each of them if more than one (the "Guarantor"), for the benefit of 
CoreStates Bank, N.A.*, a national banking association (the "Bank").

1.      OBLIGOR. the "Obligor" means the following person or entity, and 
if more than one, any or all of the following persons or entities:

			AMH (Arrow Medical Holdings) B.V.               
			---------------------------------
2.      OBLIGATIONS. The "Obligations" means all existing and hereafter 
incurred or arising indebtedness, obligations and liabilities of the Obligor 
to the Bank, whether absolute or contingent, direct or indirect and out of 
whatever transactions arising, and includes without limitation, all matured 
and unmatured indebtedness, obligations and liabilities of the Obligor 
under or in connection with existing and future loans and advances 
evidenced by promissory notes or otherwise, letters of credit, 
acceptances, all other extensions of credit, repurchase agreements, 
security agreements, mortgages, overdrafts, foreign exchange contracts 
and all other contracts for payment or performance, indemnities, and all 
indebtedness, obligations and liabilities under any guaranty or surety 
agreement, or as co-maker or co-obligor with any person for any of the 
foregoing, including without limitation all interest, expenses, costs 
(including collection costs) and fees (including reasonable attorney's fees 
and prepayment fees) incurred, arising or accruing (whether prior or 
subsequent to the filing of any bankruptcy petition by or against any 
Obligor) under or in connection with any of the foregoing.  If the term 
"Obligor" includes more than one person or  entity, the Obligations shall 
include all Obligations of any one or more of such persons or entities, 
whether such Obligations are individual, joint, several or joint and 
several.

3.      UNCONDITIONAL GUARANTY.  In consideration of any existing 
Obligations and any Obligations which may hereafter arise or be 
incurred, each Guarantor, intending to be legally bound absolutely and 
unconditionally (and jointly and severally if more than one) guaranties to 
Bank the payment, performance and satisfaction when due (whether by 
stated maturity, demand, acceleration or otherwise) of all Obligations.  
The obligations of the Guarantor hereunder shall continue in full force 
and effect irrespective of the validity, legality or enforceability of any 
agreements, notes or documents pursuant to which any of the Obligations 
arise, or the existence, value or condition of any collateral for any of the 
Obligations, or of any other guaranty of the Obligations, or any other 
circumstance which might otherwise constitute a legal or equitable 
discharge of a surety or guarantor. 

4.      COST OF ENFORCEMENT.  Each Guarantor agrees jointly and 
severally if more than one) to pay Bank all costs and expenses (including 
reasonable attorneys' fees) at any time incurred by Bank in the 
enforcement of this Guaranty against any Guarantor.

5.      PAYMENT BY GUARANTOR.  Payment by each Guarantor is due upon 
demand by Bank and is payable in immediately available funds in Dutch 
Guilders at CoreStates Bank, London, England.

6.      CONTINUING GUARANTY.  This Guaranty shall continue in full force 
and effect with respect to each Guarantor and may not be revoked until 
all existing Obligations and all Obligations hereafter incurred or arising 
have been paid, performed and satisfied in full.  Notwithstanding the 
foregoing, any Guarantor may, by written notice to Bank, terminate its 
liability hereunder with respect to Obligations which are not Pre-
Termination Obligations as hereinafter defined.  Such notice shall be 
ineffective unless sent via certified mail to: Special Notices Section, 
Commercial Loan Services, CoreStates Bank, N.A., P. 0. Box 3850, F. 
C. 6-93-1-42, Lancaster, PA 17604

The burden of establishing (i) that Bank has received any termination 
notice hereunder and (ii) the day on which such notice was received shall 
be on Guarantor.  In the event that Bank receives an effective termination 
notice from Guarantor in accordance with the provisions of this 
paragraph, such termination shall not affect Guarantor's liability (a) for 
Obligations incurred or arising on or prior to the tenth day following 
receipt by Bank of such termination notice, or any earlier day, on which 
Bank determines in good faith that the appropriate Bank officers have 
actual knowledge of Bank's receipt of such notice (the "Termination 
Effective Date"), (b) for Obligations which are renewals, modifications, 
amendments, extensions, substitutions, replacements or rollovers of, or 
which consist of accrued interest on,  Obligations incurred or arising on 
or prior to the Termination Effective Date, or (c) for Obligations incurred 
or arising pursuant to a commitment existing on the Termination 
Effective Date under which Bank was obligated to extend credit or make 
payments to Obligor or for Obligor's account, all Obligations referred to 
in this sentence being hereinafter collectively called "Pre-Termination 
Obligations".  It is understood that for purposes of this Guaranty and 
regardless of any conflicting agreement between Bank and any Obligor, 
all payments on and other reductions of the Obligations subsequent to the 
Termination Effective Date (other than payments made by Guarantor in 
respect of the Guaranty itself) shall, unless Bank elects otherwise in 
writing, be applied first to Obligations other than Pre-Termination 
Obligations, and then to Pre-Termination Obligations.  It is further 
understood that the provisions of the preceding sentence shall be 
applicable regardless of the amount of any new Obligations incurred or 
arising subsequent to the Termination Effective Date.

7.      WAIVERS AND CONSENTS BY GUARANTOR.  Each Guarantor 
unconditionally consents to, and waives as a defense to liability 
hereunder, each of the following:
(a) any waiver, inaction, delay or lack of diligence by Bank in enforcing 
its rights against any Obligor or in any property, or the unenforceability 
of any such rights, including any failure to perfect, protect or preserve 
any lien or security interest which may be intended directly or indirectly 
to secure any of the Obligations, and the absence of notice thereof to any 
Guarantor, (b) the absence of any notice of the incurrence or existence of 
any Obligation, (c) any action, and the absence of notice thereof to any 
Guarantor, taken by Bank or any Obligor with respect to any of the 
Obligations, including any release, subordination or substitution of any 
collateral or release, termination, compromise, modification or 
amendment of any instrument executed by or applicable to any Obligor or 
of any claim, right or remedy against any Obligor or any property, (d) 
any impairment of Guarantor's right to reimbursement by way of 
subrogation, indemnification or contribution, (e) any other action taken or 
omitted by Bank in good faith with respect to the Obligations, (f) the 
absence or inadequacy of any formalities of every kind in connection with 
enforcement of the Obligations, including presentment, demand, notice 
and protest, and (g) the waiver of any rights of Bank under or any action 
taken or omitted by Bank with respect to any other guaranty of the 
Obligations.

8.      OTHER AGREEMENTS BY GUARANTOR.  Each Guarantor agrees that 
there shall be no requirement that Bank document its acceptance of this 
Guaranty, evidence its reliance thereon, or that Bank take any action 
against any person or any property prior to taking action against any 
Guarantor.  Each Guarantor further agrees that Bank's rights and 
remedies hereunder shall not be impaired or subject to any stay, 
suspension or other delay as a result of Obligor's insolvency or as a result 
of any proceeding applicable to Obligor or Obligor's property under any 
bankruptcy or insolvency law.  Each Guarantor also agrees that payments 
and other reductions on the Obligations may be applied to such of the 
Obligations and in such order as Bank may elect.

9.      SUBROGATION AND SIMILAR RIGHTS.  No Guarantor will exercise 
any rights with respect to Bank or any Obligor related to or acquired in 
connection with or as a result of its making of this Guaranty which it may 
acquire by way of subrogation, indemnification or contribution, by reason 
of payment made by it hereunder or otherwise, until after the date on 
which all of the Obligations shall have been satisfied in full.  Until such 
time, any such rights against the Obligor shall be fully subordinate in lien 
and payment to any claim in connection with the Obligations which Bank 
now or hereafter has against the Obligor.  If any amount shall be paid to 
any Guarantor on account of such subrogation, indemnification or 
contribution at any time when all of the Obligations and all other 
expenses guaranteed pursuant hereto shall not have been paid in full, such 
amount shall be held in trust for the benefit of Bank, shall be segregated 
from the other funds of Guarantor and shall forthwith be paid over to 
Bank to be applied in whole or in part by Bank against the Obligations, 
whether matured or unmatured, in such order as the Bank shall determine 
in its sole discretion.  If Guarantor shall make payment to the Bank of all 
or any portion of the Obligations and all of the Obligations shall be paid 
in full, Guarantor's right of subrogation shall be without recourse to and 
without any implied warranties by Bank and shall remain fully subject 
and subordinate to Bank's right to collect any other amounts which may 
thereafter become due to the Bank by the Obligor in connection with the 
Obligations.
- ------------------------------------------------------------------------
* CoreStates Bank,  N.A. also conducts business as Philadelphia National 
Bank, as CoreStates First Pennsylvania Bank and as CoreStates Hamilton 
Bank



10.     REINSTATEMENT OF LIABILITY.  If any claim is made upon the Bank 
for repayment or recovery of any amount or amounts received by Bank in 
payment or on account of any Obligations and Bank repays all or part of 
said amount by reason of (a) any judgment, decree or order of any court 
or administrative body having jurisdiction over the Bank or any of its 
property, or (b) any settlement or compromise in good faith with any 
such claimant (including Obligor), then and in such event each Guarantor 
agrees that any such judgment, decree, order, settlement or compromise 
shall be binding upon the Guarantor, notwithstanding any termination 
hereof or the cancellation of any note or other instrument evidencing any 
Obligation, and each Guarantor shall remain liable to the Bank hereunder 
for the amount so repaid or recovered to the same extent as if such 
amount had never originally been received by Bank.

11.     SECURITY INTEREST.  Each Guarantor hereby assigns to the Bank 
and grants to the Bank a security interest in any balance or assets in any 
deposit or other account of such Guarantor in or with the Bank whenever 
and so long as any of the Obligations shall be outstanding and unpaid and 
agrees that the security interest hereby granted shall be independent of the 
right of setoff.

12.     FINANCIAL INFORMATION ON GUARANTOR.  Each Guarantor hereby 
agrees to provide the Bank with such information on the business affairs 
and financial condition of such Guarantor as the Bank from time to time 
may reasonably request and to notify the Bank of any change in the 
address of such Guarantor.  In the event that such Guarantor fails to 
comply with a request for information as herein agreed, within ten (10) 
days after receipt of the request, such Guarantor upon demand by the 
Bank agrees to purchase from the Bank without representation, warranty 
or recourse the Obligations and to pay therefor the unpaid principal 
amount of all such Obligations, including interest thereon to the date of 
purchase.

13.     EFFECT OF OTHER AGREEMENTS.  The provisions of this Guaranty 
are cumulative and concurrent with Bank's rights and remedies against 
Guarantor under any existing or future agreement pertaining or 
evidencing any of the Obligations.  No such additional agreement shall be 
deemed a modification or waiver hereof unless expressly so agreed by 
Bank in writing.  If Bank holds any other guaranty or surety agreement 
applicable to any of the Obligations, the liability of each Guarantor 
hereunder shall be joint and several with each party obligated on such 
other guaranty or surety agreement, unless otherwise agreed by Bank in 
writing.

14.     CONFESSION OF JUDGEMENT:  WARRANT OF ATTORNEY - Each Guarantor 
irrevocably authorizes and empowers any attorney or any clerk of court 
of record, upon the occurrence of a default or an Event of Default under 
or in connection with any of the Obligations, or at any time thereafter, to 
appear for and confess judgment against such Guarantor for the full 
amount of such Guarantor's liability under paragraph 3 hereof, with or 
without declaration with costs of suit and release of errors, without stay 
of execution and with an amount not to exceed the greater of five percent 
(5%) of the principal amount of such judgment or $5,000 added for 
collection fees.  If a copy of this Guaranty, verified by affidavit by or on 
behalf of Bank, shall have been filed in such action, it shall not be 
necessary to file the original of this Guaranty.  The authority granted 
hereby shall not be exhausted by the initial exercise thereof and may be 
exercised by Bank from time to time.  There shall be excluded from the 
lien of any judgment obtained solely pursuant to this paragraph all 
improved real estate in any area identified by the Federal Emergency 
Management Agency as having special flood hazards if the community in 
which such area is located is participating in the National Flood Insurance 
Program.  Any such exclusion shall not affect any lien upon property not 
so excluded.

15.     GUARANTOR'S ADDRESS.  Guarantor warrants and represents that 
the address set forth below is Guarantor's correct mailing address and 
agrees immediately to notify Bank in the event of any change therein.

16.     MISCELLANEOUS.  (a) No amendment of any provision of this 
Guaranty shall be effective unless it is in writing and signed by each 
Guarantor and Bank, and no waiver of any provisions of this Guaranty, 
and no waiver or consent to any departure by the Guarantor therefrom, 
shall be effective unless it is in writing and signed by Bank, and then 
such waiver or consent shall be effective only in the specific instance and 
for the specific purpose for which given.  (b) Any provision of this 
Guaranty which is prohibited or unenforceable in any jurisdiction shall, 
as to such jurisdiction, be ineffective to the extent of such prohibition or 
unenforceability without invalidating the remaining portions hereof or 
affecting the validity or enforceability of such provisions in any other 
jurisdiction.  (c) The obligations of each Guarantor hereunder shall not be 
subject to any counterclaim, setoff, deduction or defense based upon any 
related or unrelated claim which such Guarantor may now or hereafter 
have against Bank or any Obligor, except payment of the Obligations, 
and shall not be affected by any change in Obligor's legal status or 
ownership or by any change in corporate, partnership or other 
organizational structure applicable to Obligor.  (d) This Guaranty shall (i) 
be binding on each Guarantor and its personal representatives, estate, 
heirs, successors and assigns, and (ii) inure, together, with all rights and 
remedies of Bank hereunder, to the benefit of the Bank and its successors, 
transferees and assigns.  Notwithstanding the foregoing clause (i), none 
of the rights or obligations of any Guarantor hereunder may be assigned 
or otherwise transferred without the prior written consent of the Bank. (e) 
This Guaranty shall be governed by and construed in accordance with the 
internal laws, and not the law of conflicts, of the Commonwealth of 
Pennsylvania.

17.     CONSENT TO JURISDICTION AND VENUE. IN ANY 
LEGAL PROCEEDING INVOLVING, DIRECTLY OR 
INDIRECTLY, ANY MATTER ARISING OUT OF OR RELATED 
TO THIS GUARANTY OR THE RELATIONSHIP EVIDENCED 
HEREBY, EACH UNDERSIGNED PARTY HEREBY 
IRREVOCABLY SUBMITS TO THE NONEXCLUSIVE 
JURISDICTION OF ANY STATE OR FEDERAL COURT 
LOCATED IN ANY COUNTY IN THE COMMONWEALTH OF 
PENNSYLVANIA WHERE BANK MAINTAINS AN OFFICE AND 
AGREES NOT TO RAISE ANY OBJECTION TO SUCH 
JURISDICTION OR TO THE LAYING OR MAINTAINING OF 
THE VENUE OF ANY SUCH PROCEEDING IN SUCH COUNTY.  
EACH UNDERSIGNED PARTY AGREES THAT SERVICE OF 
PROCESS IN ANY SUCH PROCEEDING MAY BE DULY 
EFFECTED UPON IT BY MAILING A COPY THEREOF, BY 
REGISTERED MAIL, POSTAGE PREPAID, TO EACH 
UNDERSIGNED PARTY.

18.     WAIVER OF JURY TRIAL. EACH UNDERSIGNED PARTY 
HEREBY WAIVES, AND BANK BY ITS ACCEPTANCE HEREOF 
THEREBY WAIVES, TRIAL BY JURY IN ANY LEGAL 
PROCEEDING INVOLVING, DIRECTLY OR INDIRECTLY, ANY 
MATTER (WHETHER SOUNDING IN TORT, CONTRACT OR 
OTHERWISE) IN ANY WAY ARISING OUT OF OR RELATED 
TO THIS GUARANTY OR THE RELATIONSHIP EVIDENCED 
HEREBY.  THIS PROVISION IS A MATERIAL INDUCEMENT 
FOR BANK TO ENTER INTO, ACCEPT OR RELY UPON THIS 
GUARANTY.

IN WITNESS WHEREOF, each Guarantor has executed this Guaranty as 
of the 17th day of July 1996.

	ARROW INTERNATIONAL, INC.                       
	-------------------------
NAME OF CORPORATION OR PARTNERSHIP GUARANTOR

						
ADDRESS
By:     /s/Marlin Miller, Jr.               By:  /s/John Broadbent, Jr.       
	---------------------                    ----------------------
	Marlin Miller, Jr., President    John Broadbent, Jr., Vice President
			


INDIVIDUALS OR PROPRIETORS SIGN BELOW

      ---------     ----------------------    ------------------------  
       WITNESS       ADDRESS OF GUARANTOR      SIGNATURE OF GUARANTOR

      ---------     ----------------------    ------------------------  
       WITNESS       ADDRESS OF GUARANTOR      SIGNATURE OF GUARANTOR



                    				   ADDENDUM
				                          TO
		             COMMERCIAL PROMISSORY NOTE ("Note")

Note Dated:             July 17, 1996
Maker/Borrower:         AMH (Arrow Medical Holdings) B.V.
Payee/Bank/Lender:      CoreStates Bank, N.A.
Principal Amount:       20,000,000.00 Dutch Guilder

	This Addendum is a part of and is hereby incorporated into the 
Note.  In the event of any inconsistency between the terms of the Note 
and the terms of this Addendum, the terms of this Addendum shall 
control.

1.      Interest Rates and Due Date.
	---------------------------
	1.1     The entire principal balance outstanding hereunder shall        
	bear interest for each day during each Interest Period          
	hereafter established at a rate per annum to be selected by     
	the Borrower, subject to the conditions set forth herein,               
	from among the following interest rate options:

	(a)     "Interest Rate Option A": the LIBOR Rate plus           
	three-quarters of one percent (0.75%); or

	(b)     "Interest Rate Option B": a fixed rate of interest for  
	a specified Interest Period quoted by the Lender and            
	accepted by the Borrower quoted by the Lender and               
	accepted by the Borrower.

	1.2     As used herein, the "LIBOR Rate" means the interest rate 
	per annum determined by averaging the respective rates at which  
	deposits in Dutch Guilder are offered to leading banks in the 
	London Interbank Market at the Lender's request at or about 
	11:00 a.m. prevailing London time two (2) Working Days before 
	the date that the LIBOR Rate shall become applicable hereto, for a 
	period of time comparable to the Interest Period to be made 
	applicable hereto and in an amount comparable to the principal 
	amount outstanding hereunder.

	1.3     As used herein, "Interest Period" shall mean:

	(a)     with respect to Interest Rate Option B described hereinabove, 
	such period of time as the Lender shall specify in conjunction with 
	the quotation of the fixed rate; or

	(b)     with respect to Interest Rate Option A described hereinabove, 
	the following:





		(i)     initially, the period commencing on the 
		borrowing or    conversion date, as the case may be, 
		with respect to such LIBOR Rate and ending one, 
		two, three, six or twelve months thereafter, as 
		selected by the Borrower in its notice of borrowing 
		or notice of conversion, as the case may be, 
		given with respect thereto; and

		(ii)    thereafter, each period commencing on the day 
		following the last day of the next preceding Interest 
		Period applicable to such LIBOR Rate and ending 
		one, two, three, six or twelve months thereafter, as 
		selected by the Borrower by irrevocable notice to 
		the Lender;

		provided that, all of the foregoing provisions 
		relating to Interest Periods are subject to the 
		following:

		(1)     if any Interest Period pertaining to the 
		LIBOR Rate would otherwise end on a day that is 
		not a Working Day, such Interest Period shall be 
		extended to the next succeeding Working Day 
		unless the result of such extension would be to 
		carry such Interest Period into another calendar 
		month in which event such Interest Period shall end 
		on the immediately preceding Working Day;

		(2)     any LIBOR Rate Interest Period that would 
		otherwise extend beyond the Due Date of this Note 
		shall end on the Due Date of this Note; and

		(3)     any Interest Period pertaining to a LIBOR 
		Rate that begins on the last Working Day of a 
		calendar month (or on a day for which there is no 
		numerically corresponding day in the calendar 
		month at the end of such Interest Period) shall end 
		on the last Working Day of a calendar month.

	1.4     The selection by Borrower of an interest rate permitted 
	pursuant to Section 1.1 hereinabove, as well as the acceptance by 
	Borrower of an interest rated quoted by the Lender pursuant to 
	Interest Rate Option B, shall be accomplished by the Borrower 
	delivering to Lender its irrevocable written notice at least two (2) 
	Business Days prior to the proposed starting date of an Interest 
	Period for Interest Rate Option B or at least two (2) Working 
	Days prior to the proposed starting date of an Interest Period for 
	Interest Rate Option A. Such written notices from Borrower to 
	Lender shall be deemed given when received by the Lender and 
	may be transmitted by regular mail, delivery service or telecopier 
	addressed to the "Attention of Loan Administration" at the 
	following address:

	      CoreStates Bank, N.A. - London
	      Centurion House

                            					  2



	      24 Monument Street
	      London EC 3R 8AJ
	      England
	      Telecopier:     071 623 5346

	1.5     All outstanding and unpaid principal, accrued and unpaid 
	interest and any other sums remaining unpaid hereunder shall be 
	due and payable in full on July 31, 2001 (the "Due Date").  Prior 
	to the Due Date, Borrower shall pay interest quarterly, at the end 
	of each calendar quarter, or at the expiration of the applicable 
	Interest Period, if same occurs prior to the end of the then current 
	calendar quarter.

	1.6     The Borrower may on the last day of any Interest Period 
	prepay this Note in whole or in part, without premium or penalty, 
	upon at least two (2) Working Days' irrevocable notice to the 
	Lender while Interest Rate Option A is in effect or upon two (2) 
	Business Days' irrevocable notice to the Lender while Interest 
	Rate Option B is in effect, specifying the date and the amount of 
	prepayment.  Any prepayment prior to the conclusion of an 
	Interest Period shall be accompanied by the Breakage Costs.  
	Partial prepayments shall be in an aggregate principal amount of 
	$100,000.00 or a whole multiple of $50,000.00 in excess thereof.  
	Principal amounts prepaid prior to the Due Date hereunder may 
	not be reborrowed.

	1.7     As used in this Addendum, the following terms shall have 
	the following meanings:

		(a)     "Breakage Costs" shall mean the aggregate amount of 
		such costs and fees as are determined by Lender in its sole 
		reasonable discretion to be applicable and payable upon the 
		prepayment, prior to the conclusion of the then applicable 
		Interest Period as to which Interest Option A is in effect, of 
		all or any portion of this Note, including but not limited to 
		any loss, including loss of interest income, costs or expenses 
		arising from the redeployment of funds and fees payable to 
		terminate the deposits from which such funds were obtained.

		(b)     "Business Day" or "Business Days" shall mean any day 
		or days other than a Saturday, Sunday, a public holiday 
		under the laws of the Commonwealth of Pennsylvania and/or 
		the United States of America, or other day on which banking 
		institutions are authorized or obligated to close in 
		Philadelphia, Pennsylvania.

		(c)     "Working Day" shall mean any Business Day on which 
		dealings in foreign currencies and exchange between banks 
		may be carried on in London, England.



                             					3





	1.8     Inability to Determine Interest Rate.  If prior to the first 
		------------------------------------
	day of any Interest Period:

		(a)     the Lender shall have determined (which determination 
		shall be conclusive and binding upon the Borrower) that, 
		by reason of circumstances affecting the relevant market, 
		adequate and reasonable means do not exist for 
		ascertaining the LIBOR Rate for such Interest Period, or

		(b)     the Lender shall have determined that the LIBOR Rate 
		determined or to be determined for such Interest Period 
		will not adequately and fairly reflect the cost to the Lender 
		(as conclusively certified by the Lender) of maintaining the 
		loan evidenced by the Note during such Interest Period,

	the Lender shall give telecopy or telephonic notice thereof to the 
	Borrower as soon as practicable thereafter.  If such notice is 
	given, and until the same is withdrawn by the Lender in writing, 
	Interest Rate Option A shall be unavailable and Interest Rate 
	Option B shall be applicable hereto.

2.      Procedure for Borrowing.  The full principal sum shall be 
	-----------------------
advanced by the Lender to the Borrower concurrently with the execution 
of this Note and all related documentation executed in connection 
herewith, and shall be paid to or on behalf of the Borrower in accordance 
with the Borrower's written instructions.

3.      Payments.
	--------
	3.1     Any payment to be made by the Borrower hereunder shall 
	be made in immediately available cleared funds in Dutch Guilder 
	before 2:00 o'clock p.m. London time on the date on which 
	payment thereof is due by Borrower's payment to Rabo Bank, 
	Utrecht The Netherlands (SWIFT address RABONL2U), for the 
	account of CoreStates Bank, N.A. - London (Account No. 
	390804959A00NLG).

	3.2     All sums required to be paid under this Note shall be paid 
	in full without setoff or counterclaim.


                              					4

	3.3     Taxes.  All payments made by the Borrower under this 
		-----
	Note shall be made free and clear of, and without deduction or 
	withholding for or on account of, any present or future income, 
	stamp or other taxes, levies, imposts, duties, charges, fees, 
	deductions or withholdings, now or hereafter imposed, levied, 
	collected, withheld or assessed by any governmental authority, 
	excluding, in the case of the Lender, net income taxes and 
	franchise taxes (imposed in lieu of net income taxes) imposed on 
	the Lender, as the case may be, as a result of a present or former 
	connection between the jurisdiction of the government or taxing 
	authority imposing such tax and the Lender (excluding a 
	connection arising solely from the Lender having executed, 
	delivered or performed its obligations or received a payment 
	under, or enforced, this Note) or any political subdivision or 
	taxing authority thereof or therein (all such non-excluded taxes, 
	levies, imposts, duties, charges, fees, deductions and withholdings 
	being hereinafter called ("Taxes").  If any Taxes are required to 
	be withheld from any amounts payable to the Lender hereunder, 
	the amounts so payable to the Lender shall be increased to the 
	extent necessary to yield to the Lender (after payment of all 
	Taxes) interest or any such other amounts payable hereunder at 
	the rates or in the amounts specified in this Note.  Whenever any 
	Taxes are payable by the Borrower, as promptly as possible 
	thereafter the Borrower shall send to the Lender a certified copy 
	of an original official receipt received by the Borrower showing 
	payment thereof.  If the Borrower fails to pay any Taxes when due 
	to the appropriate taxing authority or fails to remit to the Lender 
	the required receipts or other required documentary evidence, the 
	Borrower shall indemnify the Lender for any incremental taxes, 
	interest or penalties that may become payable by the Lender as a 
	result of any such failure.  The agreements in this Subsection 3.3 
	shall survive the payment of this Note and all amounts payable 
	hereunder.

4.      Requirements of Law.  In the event that after the date hereof, any 
	-------------------
change in any law, regulation or treaty or in the interpretation or 
application thereof or compliance by the Lender with any request or 
directive (whether or not having the force of law) from any central bank 
or other governmental authority, agency or instrumentality:

		(i)     subjects or shall subject the Lender to any tax of 
	any kind whatsoever with respect to this Note, the loan made 
	hereunder, or changes the basis of taxation of payments to the 
	Lender of principal, interest or any other amount payable 
	hereunder (except for changes in the rate of tax on the overall net 
	income of the Lender); or 

		(ii)    imposes, modifies or holds or shall impose, modify 
	or hold applicable any reserve, special deposit, compulsory loan 
	or similar requirement against assets held by, or deposits or other 
	liabilities in or for the account of, advances or loans by, or other 
	credit extended by, or any other acquisition of funds by, any 
	office of the Lender, which reserve, special deposit, compulsory 
	loan or similar requirement is not otherwise included in the 
	determination of the interest rate hereunder; or

		(iii)   imposes or shall impose on the Lender any other 
	condition;

and the result of any of the foregoing is to, directly or indirectly, increase 
the cost to the Lender of making, renewing or maintaining advances or 
extensions of credit or to reduce any account receivable thereunder then,


                        				       5



in any such case, the Borrower shall promptly pay the Lender, upon its 
demand, any additional amounts necessary to compensate the Lender for 
such additional cost or reduced account receivable.  If the Lender 
becomes entitled to claim any additional amounts pursuant to this section, 
it shall promptly notify the Borrower of the event by reason of which it 
has become so entitled.  The good faith determination as to any additional 
amounts payable pursuant to the foregoing sentence by the Lender shall 
be conclusive in the absence of manifest error.  This covenant shall 
survive the payment of this Note and the payment of all amounts payable 
hereunder.

	(b)     If the Lender shall have determined that the adoption of or 
any change in any requirement of law regarding capital adequacy or in 
the interpretation or application thereof or compliance by the Lender or 
any corporation controlling the Lender with any request or directive 
regarding capital adequacy (whether or not having the force of law) from 
any governmental authority made subsequent to the date hereof does or 
shall have the effect of reducing the rate of return on the Lender's or such 
corporation's capital as a consequence of its obligations hereunder to a 
level below that which the Lender or such corporation could have 
achieved but for such change or compliance (taking into consideration the 
Lender's or such corporation's policies with respect to capital adequacy) 
by an amount deemed by the Lender to be material then from time to 
time, after submission by the Lender to the Borrower of a written request 
therefor, the Borrower shall pay to the Lender such additional amount or 
amounts as will compensate the Lender for such reduction.

	(c)     Notwithstanding any other provision herein, if the adoption 
of or any change in any requirement of law or in the interpretation or 
application thereof shall make it unlawful for the Lender to make or 
maintain LIBOR Rate loans as contemplated herein, (a) the commitment 
of the Lender hereunder to make the LIBOR Rate available, continue the 
LIBOR Rate as such and convert this Note to the LIBOR Rate shall 
forthwith be cancelled and (b) the sum then outstanding hereunder at the 
LIBOR Rate, if any, shall be converted automatically to Interest Rate 
Option B on the last day of the then current Interest Period with respect 
thereto or within such earlier period as required by law.  If any such 
conversion occurs on a day which is not the last day of the then current 
Interest Period, the Borrower shall pay to the Lender the Breakage Costs.

5.      Currency Conversion.  If any amount paid to or for the account of 
	-------------------
or recovered by the Lender in a currency ("Relevant Currency") other 
than the currency in which it is expressed to be due or required to be paid 
under this Note (the "Due Currency") and the amount paid or recovered 
in the Relevant Currency when converted into the Due Currency (by the 
Lender purchasing the Due Currency with the amounts so paid or 
recovered in the London foreign exchange market at or about 10:00 a.m. 
on the date of receipt after meeting all costs and expenses incurred in 
effecting such purchase (save that if such date is not a Working Day, on 
the next succeeding Working Day) is less than the relevant amount


                       				       6


originally due under this Note, the Borrower shall as a separate and 
independent obligation immediately reimburse the Lender in the Due 
Currency in respect of the amount of the shortfall and shall indemnify the 
Lender against any direct loss or damage arising as a result of a failure to 
make such reimbursement.  If the payment made in the Relevant 
Currency when converted at the applicable rate of exchange into the Due 
Currency exceeds the relevant unpaid amount originally due under this 
Note, then the Lender shall, after meeting all costs and expenses incurred 
in effecting the purchase of the Due Currency with the Relevant Currency 
and so long as no Event of Default shall then be subsisting, pay to the 
Borrower an amount equal to the amount of such excess.

6.      Indemnity.  The Borrower agrees to indemnify the Lender and to 
	---------
hold the Lender harmless from any loss or expense which the Lender may 
sustain or incur as a consequence of (a) default by the Borrower in 
conversion into or continuation of a LIBOR Rate Interest Period after the 
Borrower has given a notice requesting the same in accordance with the 
provisions of this Note, (b) default by the Borrower in making any 
prepayment after the Borrower has given a notice thereof in accordance 
with the provisions of this Note or (c) the making of a prepayment while 
Interest Option A is in effect on a day which is not the last day of the 
Interest Period with respect thereto, including, without limitation, the 
Breakage Costs.  This covenant shall survive the payment of this Note 
and all amounts payable hereunder.

7.      References in this Addendum and/or in the Note to either the 
"Note" or the "Addendum" shall be deemed to be references to both the 
Note and this Addendum, unless the context clearly requires otherwise.

	IN WITNESS WHEREOF, the Borrower, intending this to be a 
sealed instrument and intending to be legally bound hereby, has executed and 
delivered this Addendum as of the day and year first above written.

					 BORROWER:
					 --------
					 AMH (ARROW MEDICAL HOLDINGS) B.V.



				By:     /s/Marlin Miller, Jr.                           
					-------------------------------------
					Marlin Miller, Jr., Managing Director 


				Attest: /s/John Broadbent, Jr.                       
					-------------------------------------
					John Broadbent, Jr. Managing Director






                          				      7



		      EXPLANATION AND WAIVER OF RIGHTS
		      REGARDING CONFESSION OF JUDGMENT

1.      On the date hereof, Arrow International, Inc., a(an) corporation
(the "Obligor") is signing and delivering to CoreStates Bank, N.A. (the 
"Bank") a:

     ___   Promissory note in the principal sum of Dollars ($_____________);

      X    Guaranty of Obligations of AMH (Arrow Medical Holdings) B.V. 
     ---                              ---------------------------------
       	   Other_______________________________________________________
     ---
(as the same may be renewed, modified, amended, extended, restated or 
replaced, whether one or more, the "Obligation").  The Obligor has been 
advised by the Bank (and by the Obligor's legal counsel, if applicable) 
that the Obligation contains a clause that provides that the Bank may 
confess judgment against the Obligor.  The Obligor has read the 
Obligation and clearly and specifically understands that by signing the 
Obligation which contains such confession of judgment clause:

	(a)     The Obligor is authorizing the Bank to enter a 
judgment against the Obligor and in favor of the Bank, which will give 
the Bank a lien upon any real estate which the Obligor may own in any 
county where the judgment is entered;

	(b)     Obligor is giving up an important right to any 
notice or opportunity for a hearing before the entry of this judgment on 
the records of the Court;

	(c)     The Obligor is agreeing that the Bank may enter 
this judgment and understands that the Obligor will be unable to contest 
the validity of the judgment, should the Bank enter it, unless the Obligor 
successfully challenges entry of the judgment through a petition to open 
or strike the judgment, which will require the Obligor to retain counsel at 
the Obligor's expense;

	(d)     The Obligor may be giving up an important right to 
any notice or opportunity for a hearing before the Bank may request and 
use the power of the state government to deprive the Obligor of its 
property pursuant to the judgment by seizing or having the Sheriff or 
other official seize the Obligor's bank accounts, inventory, equipment, 
furnishings, or any other personal property that the Obligor may own, to 
satisfy the Obligation;

	(e)     The Obligor may be immediately deprived of the 
use of any property that is seized by the Bank pursuant to the judgment 
without notice or a hearing, and the procedural rules of Pennsylvania's 
court system do not guarantee that the Obligor will receive a prompt 
hearing after the Obligor's property is seized; and

	(f)     If the Obligation is the Bank's printed form of 
Master Demand Note, Commercial Promissory Note or Security 
Agreement, or a Master Note Agreement prepared by the Bank, the 
Obligor is agreeing that the Bank may enter judgment whether or not 
there is a default under the Obligation.



2.      The Obligor knows and understands that it is the confession of 
judgment clause in the Obligation which gives the Bank the rights 
described in subparagraphs (a) through (f) of paragraph 1 above.

3.      Fully and completely understanding the rights which are being 
given up if the Obligor signs the Obligation containing the confession of 
judgment, the Obligor nevertheless freely, knowingly and voluntarily 
waives said rights and chooses to sign the Obligation.

4.      Obligor acknowledges that the proceeds of the Obligation are to 
be used for business purposes.

5.      If the Obligor is an individual, the Obligor certifies that his/her 
annual income exceeds $10,000.00.



Dated this 17th day of July, 1996.


THE OBLIGOR HAS READ THIS EXPLANATION AND WAIVER 
PRIOR TO SIGNING THE OBLIGATION AND FULLY 
UNDERSTANDS ITS CONTENTS.



			ARROW INTERNATIONAL, INC.                       
			---------------------------------
			[Name of Corporation/Partnership]

By:     /s/Marlin Miller, Jr.         By: /s/John Broadbent, Jr.               
	-----------------------------     -----------------------------------
	Marlin Miller, Jr., President     John Broadbent, Jr., Vice President  
	-----------------------------     -----------------------------------
	   (Print name and Title)                (Print name and Title)  


			
	INDIVIDUALS OR PROPRIETORS SIGN BELOW

	       --------------------        ----------------------------------   
		(Witness Signature)         (Signature of Individual Obligor)       
		

	       --------------------        ----------------------------------   
		(Witness Signature)         (Signature of Individual Obligor)       





CORPORATE ACKNOWLEDGMENT

COMMONWEALTH OF PENNSYLVANIA

COUNTY OF

	On the 17th day of July, 1996, before me, a notary public for said 
Commonwealth and County, the undersigned officer, personally appeared 
Marlin Miller, Jr. and John H. Broadbent, Jr. who acknowledged 
themselves to be the President and Vice-President of Arrow International, 
Inc. and that they, as such officers, being authorized to do so, executed 
the foregoing Explanation and Waiver of Rights Regarding Confession of 
Judgment for the purposes therein contained by signing the name of the 
corporation by themselves as such officers.  And said Marlin Miller, Jr. 
and John H. Broadbent, Jr. did further certify and acknowledge that they 
received a true, correct and complete copy of the foregoing Explanation 
and Waiver of Rights Regarding Confession of Judgment. 

	IN WITNESS WHEREOF, I have hereunto set my hand and official seal.

  /s/ Maureen C. Zielaskowski
  ---------------------------           Notarial Seal
  Notary Public                         Maureen C. Zielaskowski, Notary Public
  My Commission Expires July 27, 1998   Bern Twp., Berks County
  Seal                                  My Commission Expires July 27, 1998



	PARTNERSHIP ACKNOWLEDGMENT

COMMONWEALTH OF PENNSYLVANIA

COUNTY OF

	On the ______ day of ______, 19__, before me, a notary public for 
said Commonwealth and County, the undersigned officer, personally 
appeared ______________ who acknowledged himself/herself/themselves 
to be General Partner(s) of _________________, a partnership, and who, I am 
satisfied is/are the person(s) named in and who executed the within 
Explanation and Waiver of Rights Regarding Confession of Judgment and 
he/she/they severally acknowledged that he/she/they signed, sealed and 
delivered the same as the act and deed of the said partnership for the uses 
and purposes therein expressed by signing the name of the partnership by 
himself/herself/themselves as partner(s).  And said __________ and that 
they, each did further certify and acknowledge that he/she/they received a 
true, correct and complete copy of the within Explanation and Waiver of 
Rights Regarding Confession of Judgment.

	IN WITNESS WHEREOF, I have hereunto set my hand and official 
seal.

		
	Notary Public
	My Commission Expires
	Seal

	INDIVIDUAL ACKNOWLEDGMENT

COMMONWEALTH OF PENNSYLVANIA

COUNTY OF

	On the _________ day of _______, 19__, before me, a notary public 
for said Commonwealth and County, the undersigned officer, personally 
appeared ____________ who, I am satisfied is/are the person(s) named 
in and who executed the within Explanation and Waiver of Rights 
Regarding Confession of Judgment and he/she/they did severally 
acknowledge that he/she/they signed, sealed and delivered the same as 
his/her/their act and deed for the uses and purposes therein expressed.  
And said __________________ did further certify and acknowledge that 
he/she/they received a true, correct and complete copy of the within 
Explanation and Waiver of Rights Regarding Confession of Judgment.

	IN WITNESS WHEREOF, I have hereunto set my hand and official 
seal.

		
	Notary Public
	My Commission Expires
	Seal