Many patients do not understand the characteristics of different types of prosthetic valves thoroughly enough before surgery, or hesitate, or simply tell the doctor, “Doctor, give me the best valve.” In fact, there are different types of prosthetic valves with different characteristics, each with its own advantages and disadvantages, and there is no such thing as an absolute good one, nor is the expensive one the right one. Therefore, we usually have to spend a relatively long time to go into details. Below we will talk to you in detail about those things about valve selection. Artificial valves have two kinds of mechanical and biological valves (1) the advantages of mechanical valves: mechanical valves are designed to have a longer life than biological valves, and a replacement valve can be used basically for life. Disadvantages: A. Mechanical valves installed into the body, long blood clots, in order to prevent the formation of blood clots, the need to take anticoagulants (warfarin) for life. At the same time, in order to adjust the dose of warfarin, you need to go to the hospital on a regular basis to take blood tests to monitor the anticoagulation index. In this regard, it is necessary to consider how far away from the nearest hospital one lives, whether it is convenient to have the checkup, and whether that hospital can do routine blood coagulation checkups, which foods to eat, which medications to take will have an effect on the anticoagulation effect, and other practical issues, which may affect the patient’s quality of life after the operation. b. Overdose of warfarin can lead to bleeding, and underdose of warfarin can lead to blood clots. c. In a quiet environment, one may sometimes hear the sound of “chest” in the chest. C. In a quiet environment, sometimes you will hear a “ticking” sound in the chest, which is generated by the mechanical valve work and is a normal phenomenon. However, if you are very sensitive to noise and suffer from insomnia for many years, you have to take this into consideration when choosing a valve. Of course, the vast majority of patients can accept and adapt to this sound. d. Taking warfarin during pregnancy may lead to fetal malformations, and women of childbearing age who are ready to replace their valves should consider this point carefully, while men do not have this problem, which will be described in detail later. (2) The characteristics of the biologic valve are opposite to those of the mechanical valve. The advantages are: there is no need to take anticoagulant medication for the rest of your life, only for 3-6 months, and only during this period, regular blood tests are required. If there is no atrial fibrillation, warfarin anticoagulant therapy can be discontinued after 3-6 months, and therefore the risk of thrombosis and bleeding associated with it is greatly reduced. The disadvantages are: poorer durability than mechanical valves, shorter life span than mechanical valves, and damage to the bioprosthetic valve over time. As a result, once the bioprosthetic valve has been damaged after several years of surgery, a second valve replacement surgery is indicated. In general, the younger the patient, the faster the bioprosthetic valve breaks down, the shorter its life span, and the greater the chance of a second surgery. How long does a bioprosthetic valve last for each patient? It is impossible to give a definitive answer to this question, as the lifespan of a valve varies depending on the patient’s physical condition, metabolic status, exercise level, basal heart rate, blood pressure, etc. The life expectancy of a valve varies depending on the patient. Therefore, when choosing a valve, you need to anticipate the possibility of a second surgery. Mechanical valves and bioprosthetic valves are not absolutely good or bad, each has its own advantages and disadvantages. The choice of which valve to use depends on the patient’s age, general condition, co-morbidities, as well as his or her own life, work, physical strength, psychological factors, and financial conditions, and sometimes requires discussion between the medical professional and the patient. Summary: In general, biological flaps are suitable for the following situations: (1) Women of childbearing age who wish to become pregnant. This is because there is a possibility that taking warfarin before and during pregnancy in patients who have a mechanical flap replacement may cause fetal malformations, bleeding, and other problems. This problem can be avoided if the biologic flap is replaced. (2) As far as age is concerned, mitral valve replacement over 65 years old and aortic valve replacement over 60 years old can be preferred for biologic valves. (3) Suffering from hemorrhagic diseases or being hemorrhagic themselves, they cannot take anticoagulants for a long time. (4) In remote mountain villages where long-term anticoagulation monitoring is not possible. (5) Those who do not want to use mechanical flaps, do not want to run to the hospital frequently for blood tests (even if it is once a month), and require a higher quality of life. (6) Patients with relatively poor general condition and physical fitness (not expected to live long). (7) Patients in sinus rhythm.