Implantation of tissue or mechanical valves is usually based on the age of the patient, but there is no consensus on a clear age cutoff for choosing whether a biologic or mechanical valve is better. The first step is to understand the respective advantages and disadvantages of mechanical and biologic valves. The advantage of mechanical valves is that they are long-lasting and theoretically permanent. The disadvantages of mechanical valves are: 1) the need for lifelong anticoagulation therapy and monitoring of coagulation; 2) the seriousness of the consequences in the event of mechanical failure; 3) the potential for valve noise to disturb the patient; and 4) the need for appropriate restrictions on diet and activity. Advantages of bioprosthetic valves: ① good hemodynamics and no noise; ② most do not require prolonged anticoagulation therapy, reducing the need for medications and blood tests; and ③ less risk of clot formation. The disadvantage of biologic valves is the formation of calcification over time and the potential risk of reoperation to replace the valve. Mechanical valves currently mainly use newer bilobed valves, in which both leaflets can open and close simultaneously. Artificial biologic valves are mainly xenogeneic tissue biologic valves, such as porcine and bovine pericardial valves. The two most important indicators for evaluating bioprosthetic valves are good durability and excellent hemodynamic performance. Comparison of bovine pericardial valves with porcine valves: (1) bovine pericardial tissue is regular and dense, with twice the collagen content of porcine valves, making it an ideal material for leaflet processing, durable for longer and less likely to tear; and (2) through optimized bioengineering, the effective opening area of bovine pericardial valves is superior to that of the same type of porcine valves. The current general consensus is that biologic valves are suitable for: ① elderly patients, aged 60 years or older; ② patients who cannot tolerate lifelong anticoagulation therapy due to implantation of a mechanical valve for lifestyle reasons; ③ women of childbearing age who are pregnant or planning to become pregnant; and ④ patients who have a high quality of life and do not want to be restricted in terms of diet, medication, and exercise. In conclusion, when choosing a prosthetic valve for valve replacement, it is important to give an individual assessment and make a final decision based on the advantages and disadvantages of the valve, lifestyle, patient age, and basic individual circumstances.