Prosthetic cardiac valves

Over the last forty years there have been major advances in cardiac surgery making it safer and more widely available. Technical advances in design and production have resulted in more durable and reliable prosthetic valves. As a result of these factors, valve replacement surgery is now frequently offered to patients. However, the perfect prosthetic valve has yet to be developed. The advantages of each type of valve must be weighed against its disadvantages; for example mechanical valves offer low rates of degeneration but require the patient to be anticoagulated to avoid thromboembolic complications. This article describes the choice of valves available, their benefits, durability and complications. We also describe the major indications and contraindications of each valve type and discuss appropriate valves for different groups of patients.