In this study we attemped to determine prospectively guidelines for the optimal management of patient with valvular heart disease. At present, most of valvular heart diseases are susceptible for surgical management. it is suitable to perform the surgical management in the best moment to achieve better results.

The question is:

when this best moment has been lost? The present study was undertaken to qualify the best operative timing for the surgical management of the valvular heart disease, and to analyza when it should be considered late for the indication of the operative procedure