Heart valve disease is a common cause of heart valve failure around the world, including rheumatic cardiomyopathy, coronary arteriosclerosis, congenital heart disease, infection and trauma. According to the analysis, cardiovascular disease has taken the first place among the causes of death in our population. The incidence of rheumatic heart valve disease in adults in China is 2.34‰-2.72‰, and according to the estimate of 1 billion population, there are about 1.5 million adult patients with rheumatic heart valve disease. Patients who may need to perform artificial heart valve replacement surgery due to severe valve lesions, about 200,000 cases, most of these patients are young adults, if they cannot have timely surgery for valve replacement, it will cause incalculable loss to the society. The indications for prosthetic heart valve replacement surgery are based on the degree of damage to the patient’s heart valve. Patients with severe valve lesions that are not amenable to shaping surgery should strive for valve replacement surgery as long as their general condition allows, and there is no absolute limit to the age of the patient. Some common lesions are briefly described as follows: 1, mitral stenosis: If the valve leaflets are active and only the junctional adhesions or mild subvalvular damage are present, closed dilatation or direct visualization shaping can be pursued. If the valve is calcified or has funnel-like changes, valve replacement surgery is required; 2, mitral valve insufficiency: mitral valve annulus enlargement or junctional confinement of leaflet coiling can be pursued with direct vision angioplasty. In cases of leaflet perforation, tendon rupture, etc., mitral valve replacement surgery is appropriate if it is difficult to completely correct the problem or if the procedure fails. Mitral stenosis combined with mitral valve insufficiency, most of which requires valve replacement; 3, tricuspid valve damage: usually tricuspid valve does not do valve replacement surgery. Only when the lesion is severe is valve replacement surgery performed; 4, aortic stenosis: congenital aortic stenosis can often be implemented in adolescence with direct vision incision surgery, middle-aged and elderly aortic stenosis is mostly due to calcification on the basis of congenital aortic valve diastasis malformation. Aortic valve replacement surgery is required; 5, aortic valve closure insufficiency: aortic valve closure insufficiency can be caused by valve annulus enlargement, leaflet tear perforation, curvature or prolapse, etc., and valve replacement surgery should usually be performed. Only mild prolapse of the aortic valve may be done with shaping surgery; 6, pulmonary valve lesions: mostly congenital malformations, rarely require valve replacement and often require the implementation of right ventricular-pulmonary artery diversion with valve conduit. Relative contraindications to prosthetic heart valve replacement surgery: 1, rheumatic activity is not controlled or controlled for less than 3 months; 2, heart failure combined with myocardial ischemic damage, such as patients with advanced aortic stenosis, cardiac function has improved, but still strive for surgery; 3, liver, kidney function or systemic conditions are too poor to withstand surgery; 4, patients with bacterial endocarditis have sepsis and multiple infections should not be operated . Selection of prosthetic heart valves: The type of prosthetic valve used in valve replacement surgery should be analyzed on a case-by-case basis. The patient’s age, occupation, physical strength, mental status, the patient’s opinion on valve selection, the patient’s myocardial condition, and the patient’s ability to receive long-term anticoagulation therapy should be considered. Biologic valves have good hemodynamics, low thromboembolic rates, and may not require long-term anticoagulation in some patients; however, the greatest disadvantage of biologic valves is their poor durability. Therefore, biologic valves are mainly used in patients who are: 1) of childbearing age who wish to become pregnant; 2) of age, biologic valves should be preferred in patients over 60 years of age and mechanical valves should be preferred in patients under 50 years of age to ensure durability and to avoid calcification of biologic valves in adolescents; 3) of bleeding quality and bleeding disorders and other reasons that preclude long-term anticoagulation; 4) of age, depending on the patient’s The tricuspid valve has the highest rate of thromboembolism of all valve replacement emboli, which may be related to the low pressure and slow blood flow at this site. This may be related to the low pressure and slow flow in this area. Clinical observations show that the thromboembolic rate in the tricuspid region is highest with disc valves, second highest with ball valves, and lowest with biologic valves; therefore, the use of biologic valves for tricuspid valve replacement is ideal. The durability of mechanical valves is good, and for the time being, they require lifelong anticoagulation after implantation in the heart regardless of the material used. The safety of valve surgery has improved significantly with advances in cardiac surgery and extracorporeal circulation technology as a whole. The mortality rate for valve replacement surgery is currently around 5% and is not significantly related to the type of prosthetic valve. The major risk factors for valve replacement surgery are: the patient’s physical status before surgery, primarily cardiac compensatory function and pulmonary vascular disease; and additional cardiac surgery, such as valve replacement with coronary artery bypass grafting, which is more risky. Currently, it is not very difficult to operate again even if the patient is older or.