Indications for Valve Replacement in Patients with Valvular Heart Disease

Cardiac valve replacement or valve repair has changed the prognosis of patients with valvular heart disease and has improved long-term survival. With the progress in operative techniques and better patient selection, results of valve replacement has been improving. The timing of valve replacement is of utmost importance in the surgical treatment aiming to diminish the symptoms, to improve the exercise capacity and quality of life. An early valve replacement places the patients at unneccessary risk of the operation and complications of prosthetic heart valves. On the otherhand, the expected outcome may not be obtained if the valve replacement is made too late. In this article the natural course of valvular heart disease, the role of operation, appropriate indications for valve replacement and factors affecting the postoperative prognosis, especially left ventricular dysfunction, have been reviewed.