الفهرس 
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Abstract
The developed countries witnessed a dramatic decline in the incidence of RF and the prevalence of RHD in the 20thcentury; however, this has continued to be major health care concern in the developing countries among both children and adults.RHD is endemic in Egypt, a high proportion of patients with RHD are youngwith mean age in our study of 32.7±10 years.
The reasons for high incidence of RF in developing countries might be the climate, poor socioeconomic conditions and overcrowding, purulent streptococcal infections, and lack of access to proper medical facilities.Valves affected by RF deteriorate rapidly due to recurrences that lead to severe debilitating disease and early death.Some cases may be suitable for valve repair, thisalong with strictprophylaxis buys some time in patients who present early, but most require valve replacement.
Since rheumatic heart affection is more severe and the degree of valvular damage is greater in developing countries than in developed communities, it seems appropriate to examine the incidence and extent of LVD in Egyptian patients. Left ventricular dimensions and function were therefore investigated in a group of patients with RHD (stenosis or regurgitation) who were referred for MVR.
Over the period of 12 months between December 2012 and December 2013, 60 patients (19 males, and 41 females) with rheumatic mitral valve diseases (stenosis or regurgitation) were admitted toCardiothoracic Surgery Unit, Minia University Hospital, and underwent MVR. These patients classified into two groups; control group (30 patients with normal preoperative EF: 55-75%), and study group (30 patients with impaired preoperative EF: <55%).