The majority of heart valve disease in children is dominated by mitral valve closure insufficiency and severe hemodynamic changes leading to episodes of heart failure. Postoperative complications after valve replacement in children are few, and early survival rates do not differ from those of adults. Given the special problems of valve replacement in children, the following two points are noted: 1. There is no ideal replacement for heart valves in children, and it is difficult to avoid re-replacement of small-sized valves as they develop and grow; 2. There are many variables in heart valve disease after valve replacement, unlike in adults, such as valve selection, bleeding complications after anticoagulation, embolism, rheumatic activity, and reoperation. Therefore, the selection of indications for valve replacement in children is more stringent, and in principle, valve lesions are repaired using pharmacologic methods whenever possible. Geriatric heart valve disease in elderly patients with rheumatic heart disease is mostly combined with other diseases, such as coronary heart disease, diabetes, hypertension, pulmonary and renal insufficiency. This is an important factor that affects the outcome of the procedure. The valve of choice is a biologic valve, which is durable enough to meet the natural lifespan. Therefore, the selection of indications for valve replacement in the elderly is focused on the basic clarification of the etiology and combined diseases through various examinations; the purpose of surgery is to prolong the life span of the patient and to improve the quality of life, and whether this standard can be achieved, the surgical indications must be considered.