Whether or not valve surgery can be performed in severe heart failure needs to be determined specifically. In the acute phase, the condition should be stabilized and then valve surgery should be performed. If the heart failure is too severe to tolerate surgery, then conservative treatment should be used. Acute heart failure should be treated with medications, such as furosemide, levosimendan, and dobutamine, to increase myocardial contractility and improve cardiac function, and then valve surgery should be considered after the condition is stabilized. If the heart failure is severe, in the late stage of valve disease, the significance of surgery is not obvious. Then medications as well as daily care should be chosen to improve the quality of life. Valve surgery is more complicated, requiring general anesthesia, open chest, extracorporeal circulation, etc. Surgery is risky, and should be chosen as much as possible when the heart is in good functional status.