In most instances cardiac valve disease is treated surgically by either replacing or by reconstructing the diseased valve. Recently, more insight has been gained in the field of bioprostheses for cardiac valve replacement. Allograft (homograft) valve replacement is traditionally the first choice in acute aortic valve endocarditis. Recently, mitral homograft implantation has been developed, with good short-term results in acute endocarditis. The pulmonary autograft in the Ross procedure is well suited for valve treatment in children and young adults owing to its potential for growth, excellent haemodynamics, and low risk of infection, thrombosis and embolic complications without anticoagulation treatment. Stentless heterograft prostheses in aortic position were recently developed and are likely to provide a good option for aortic valve replacement in the small aortic root. Finally, whenever a mitral valve replacement is required by a mechanical or stented bioprosthesis, novel techniques have been developed to combine this with the preservation of the entire subvalvular apparatus. This procedure preserves postoperative left ventricular function.