Valve replacement—a perspective

Several potential hazards in the evaluation of patients with valve replacement are emphasized. A more uniform method of analysis of data is urgently needed. In the symptomatically disabled patient aortic and mitral valve replacement have improved both the quality of life and the length of life, provided that the disease is not far advanced. Anticoagulation with sodium warfarin is still needed in patients with prosthetic valves. Many important questions, including those related to ventricular function and choice of prosthetic devices, remain unanswered. The cost-benefit ratio and a weighting of various complications of valve replacement should be assessed. Many factors have to be taken into account before considering valve replacement early in the course of the patient's disease.