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In mitral valve replacement for mitral stenosis the persistence of a depressed cardiac performance immediately after operation has been outlined by several authors. The choice of a porcine central flow prosthesis, that has several theoretical advantages, should allow better acute hemodynamic results. Therefore ten patients have been studied by thermodilution methods and the variations in their hemodynamic parameters has been evaluated with a paired T-Test. Results confirm the persistence of a depressed cardiac function throughout the time span of the study (36 hours). This behaviour could be related to the use of Kirsch solution for myocardial protection. Therefore the authors compare a similar group of nine patients that underwent mitral valve replacement with differently designed prosthesis and the use of a St Thomas analogue cardioplegic solution. They conclude for the persistence, in the acute postoperative period, of an intrinsic myocardial dysfunction.