Abstract： Objective To explore the safety,feasibility and perioperative management of gynecological laparoscopy surgery for patients with mechanical heart valves.Methods Totally 76 patients with mechanical heart valves from January 2008 to May 2014 underwent gynecological laparoscopy surgery [low flow (＜ 2 L/min) and low pneumoperitoneum pressure (8-12 mmHg)].Twenty seven cases had laparoscopic assisted transvaginal hysterectomy;15 cases had laparoscopic hysterectomy and bilateral adnexectomy;6 cases had laparoscopic myomectomy;15 cases had laparoscopic unilateral adnexectomy;9 cases had laparoscopic ovarian cyst removal surgery;4 cases had laparoscopic salpingectomy.Indicators such as length of operation time,blood loss,exhaust time,days of hospital stay were observed during and after operation.The hemoglobin,international standardization ratio (INR),D-dimer,brain natriuretic peptide (BNP),high-sensitivity troponin (hs-cTn),left ventricular ejection fraction (LVEF) and transvalve pressure were compared before and after operation.Perioperative management was carefully adjusted.Results The operations were all successfully performed.Compared with those in uterine operations,the length of operation time,blood loss,exhaust time and days of hospital stay in accessories operations were less.There were no statistical differences of hemoglobin,INR,D-dimer,BNP,hs-cTn,LVEF and transvalve pressure before and after operation (P ＞ 0.05).No adverse events including arrhythmia,cardiac dysfunction,infective endocarditis,pulmonary embolism,deep venous thrombosis occurred during and after operation.All the operative incisions were primary healing,with neither abdominal cavity internal hemorrhage nor incision bleeding.After 6-24 months,of follow-up,the heart valves were all in good condition;no thromboembolic or hemorrhagic diseases occurred and no changes of cardiac function were observed.Conclusion Gynecological laparoscopy surgery is safe and feasible for patients with mechanical heart valves.