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my career started in the early 80s and for the past 20 years I have performed a lot of mitral and aortic valve surgery and so tricuspid valve surgery either repair or replacement so that I would say that my my clinical activity is focused on for about 80% into Bob surgery right now the indication for heart valve surgery are obviously different from a or tick valve and mitral valve the aortic valve are the most frequent indication for your tick Bob surgery is aortic stenosis the bob becomes very classified and doesnt open up anymore so there is no medical therapy for this condition and we just have to replace this valve for the mitral valve the most frequent indication for mitral valve surgery is mitral regurgitation the bob is leaking a lot so for aortic valve surgery we have to replace the valve when the mob is stenotic and narrow if we have a miter bar prolapse with mitral valve regurgitation or mitral valve leak we can repair that valve with a high incidence of success over 90% if