Results of Mitral Valve Replacement: The risk of mitral valve replacement is reported as 3-5 per cent. It also depends on multiple factors like age, functional class, concomitant coronary artery disease and other medical problems. In patients with suprasystemic PH and concomitant medical problems the risk may be as high as'10-20 per cent. Even if the patient is in class IV heart failure surgery should not be denied, as the outcome of conservative treatment is very poor. The inherent problems of prosthetic valves and anticoagulation related complications make a repair procedure more attractive if there is a chance to save one's own valve.