Criteria for high surgical risk are: left ventricular failure, coronary artery disease, previous cardiac surgery for coronary artery bypass , chronic obstructive pulmonary disease, and/or advanced age and comorbidity , which can be a contraindication to intervention. Frequently cardiac surgery is not performed in elderly patients for the high surgery risk. In the Euro Heart Survey up to 33% of patients with single valve disease, New York Heart Association class III or IV, were not operated for concomitant disease or reduced life expectancy.