Acknowledgment

Thanks are all to Allah for blessing me this work until it has reached its end, as a little part of his generous help throughout my life. I wish to express my deep gratitude and profound appreciation to Prof. Dr. Ahmed Labib Dokhan Professor and Head of Cardiothoracic Surgery Department Faculty of Medicine, Menofia University, for his wise guidance, unfailing advice and constructive criticism. I am greatly indebted to Dr. Allaa Abdel-azem El-sessy Assistant Professor of General Surgery Department Faculty of Medicine Menoufia University, for his valuable help and kind supervision. I am also greatly indebted to Dr. Islam Moheb Ibrahim Lecturer of Cardiothoracic Surgery Department Faculty of Medicine Menoufia University, for his valuable help, great interest and kind supervision.
I do not forget to thank those patients included in this study for their corporation and their trust. Also, I would like to thank staff members, colleagues, and employees in cardiothoracic and general surgery departments. Who in one way or another helped me in this work. And as I

started I end by thanking Allah to whom all good things are related.