[Contribution of surgery in advanced valvular diseases].

Technical advances and progress in resuscitation over the last ten years have led to an appreciable improvement in the surgical results of valve replacements. However, it appears that the decision to operate is sometimes difficult in cases of advanced valvular disease. A study of the literature and our own experience lead us believe that despite a significant peri-operative mortality, surgical treatment remains the best form of treatment for these types of valvular disease, whether aortic, mitral or multivalvular. Surgery ensures a longer survival of better quality than does medical treatment. A better understanding of the natural history of valvular disease should enable us to refer those patients to surgeons who will benefit most from a valve replacement.