[Criteria of operability for advanced valvular diseases]

Despite the advances made in cardiac surgery, there are still some cases of valvular disease which remain inoperable, i.e. patients who present an operative risk which is too high in relation to the natural history of the disease. A study of the literature does not enable us to define objective clinical or investigational parameters of inoperability, but only factors of poor prognosis. Although there does not appear to be any cardiac contra-indications to valve replacement in cases of advanced valvular disease, the authors stress the importance of the patients general condition which determines the post-operative prognosis and the need for a better definition of the criteria of poor prognosis so that surgery can be performed before it is too late.