الفهرس 
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Abstract
The material of the present study comprised ~ 98 palients who have done cardiac surgery ~ 59 females and 39 males . Their age ranged from 1-54 years (mean 24.25 +7.6) and 13 patients who have done thoracic surgery, 12 male and one female .their age ranged from 5-60 years (mean 28.61+2.3) . The subjects of this study who were be subjected to cardiac or thoracic surgery were selected from the . inpatient Cardiothoracic surgery Departement of Mansoura University Hospital . Excluded from this study patients with 8ll)1 of the following ~ hemorrhagic blood diseases, tuberculosis, as well as patients who were subjected to operation for preicardiul disease . Patients were classified into two main groups ~ • Cardiac group: Included (98 cases) who have undergone cardiac surgery . • Chest group: Included (13 cases) who have undergone thoracic surgery . • Cardiac group: Is further subdivided into four subgroups; based on nature of disease and type of operation: - ,- Closed mitral valvotomy : Included patients with rheumatic mitral stenosis who were subjected for closed mitral valvotomy diseases (43 cases) . Open rheumatic surgery group: Included patients with rheumatic heart diseases who were subjected to open heart surgery and includes ~ open mitral valvotomy (7 cases) . _ Open mitral valve repair (11 cases) .