[Management of the prosthetic heart valve patient in clinical practice]

In use since 1961, valvular prostheses allow the correction of the severe valvular diseases when conservatrice procedures are not possible. Current prostheses have outstanding haemodynamic features. Mechanical prostheses have a supposedly unlimited life span but require anticoagulant treatment. Bioprostheses do not need such treatment but end up to deteriorate and need reoperation. Both can be affected by valve-related complications (thromboembolic events, endocarditis, deterioration, desinsertion...): an ideal prosthesis does not exist yet. All patients with valvular prosthesis require close follow-up, where echocardiography holds preeminent place.