الفهرس 
Surgical management of valvular heart diseasesOnly 14 pages are availabe for public view
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Abstract
Introduction: Management of VHD is variable and although, valve replacement is mandatory in many cases; but it still has its unique complications. In another meaning; valve replacement replaces the already exsisiting disease by another one. Prosthetic heart valves are divided into two main groups (mechanical and biological) and the choice between them in adults is determined by assessing the risk of anticoagulant-related bleeding with a mechanical valve versus the risk of structural failure with a bioprosthesis. There is no ideal prosthetic valve (inspite of the multiple designs has been manufacrured since its first application in 1960) as described by Harken, at 1989 which would be durable, non-thrombogenic, no need for anticoagulation, with no inherent gradient, easily implanted. Transesophageal echocardiography is very valuable in the assessment and evaluation of prosthetic valves function that are not adequately visualized bytransthoracic echocardiography. Aim of work: The aim of this work was to review and analyze the reported data among patients with prosthetic heart valve replacement that could elucidate the natural history of their disease as regard indications of valve replacement, surgery and timing for operation, follow up management, complications and survival, as well as the design and developmental progress in prosthetic manufactures. Conclusions: Organized and routine follow up is highly recommended in those patients with PHV and clinical assessment should be performed as soon as possible if new cardiac symptoms occur. A complete baseline assessment should be ideally performed after surgery. This reference assessment is of greatest importance to interpret subsequent changes in murmur, prosthetic sounds, as well as ventricular function and transprosthetic gradients as assessed by Doppler echocardiography