When a patient is informed of the need for a prosthetic heart valve replacement, an immediate question is which valve to choose, specifically, a mechanical or a biologic valve? This depends on which prosthetic valve complications the individual patient wishes to avoid or minimize. Here I refer to the foreign literature and briefly provide the following principles for physician and patient reference. Factors to be considered in selecting an appropriate prosthetic heart valve: 1) patient age; 2) co-morbidities: cardiac or non-cardiac; 3) patient life expectancy; 4) the prosthetic valve to be selected: (1) should not require “root replacement” but only simple aortic valve replacement for simple aortic valve lesions; (2) (2) have good long-term outcomes; and (3) meet the technical standards of the hospital and physicians. (5) patient compliance with the necessary anticoagulation therapy; (6) patient’s personal wishes or expectations; and (7) other special reasons.