Patient: The patient has been suffering from the disease since he was more than 10 years old, and has not received effective treatment, and wants to undergo surgery. The aorta and pulmonary artery are not wide. The mitral valve, tricuspid valve, and aortic valve are all thickened and echogenically enhanced, with restricted opening and poor closure, and the maximum open area of the mitral valve is approximately 1.0 cm2. Pump function:EF57%. 2, color and spectral features: mitral regurgitation can be seen in large amounts, aortic valve, tricuspid valve, pulmonary valve can be seen in medium regurgitation, tricuspid regurgitation pressure difference 69 mmHg. aortic valve, tricuspid valve antegrade flow velocity are increased, aortic valve transvalvular pressure difference 30 mmHg . Ultrasound suggests: rheumatic heart disease mitral stenosis (severe) with massive regurgitation aortic valve hypertrophy with mild stenosis and moderate regurgitation tricuspid valve stenosis (moderate) with moderate regurgitation pulmonary valve moderate regurgitation pulmonary hypertension please reply thank you doctor doctor: hello. Your information is quite detailed and I think it is the appropriate time to perform valve surgery. The mitral and aortic valves should be replaced with artificial mechanical valves. The tricuspid valve requires intraoperative exploration and can usually be shaped, or in some individual patients, replaced. The cost of hospitalization is about$80,000 if two imported valves are replaced, and about$100,000 if three valves need to be replaced. Please decide on surgery as soon as possible and do not wait for your heart to continue to oversize or have severe heart failure, which is much riskier and more expensive. Patient: Dr. Chen: Hello, do you mean that my mother’s heart aortic valve also needs to be replaced? Doctor: I think that your mother’s aortic valve also needs to be replaced because your mother’s current aortic valve has been invaded by rheumatism and has clear pathological changes, as well as functional changes of stenosis and incomplete closure. Keeping such a valve would be detrimental to postoperative recovery and long-term cardiac function, and such a valve would not last many years before needing to be replaced again. A second surgery would be more difficult. In addition, your mother’s tricuspid valve is also worth noting. In general, tricuspid valves are mostly functional and can be repaired due to incomplete closure. However, your mother’s tricuspid valve is organically altered and has stenosis, and such a valve is sometimes difficult to repair intraoperatively and may be replaced.