Background:  Adherence is a dynamic, multidimensional process in which many factors play a part. The patients understanding of the surgical procedure, informed consent, and adherence to treatment protocols are evaluated. Helping the patient to cope, understand the procedure, and maintain dignity are nursing responsibilities. Aim: This study aimed to assess factors affecting adherence to therapeutic regimens among patients with cardiac valve replacement. Design: A descriptive exploratory design was conducted to achieve aim of this study. Setting: the study was carried out in cardiac surgery outpatient clinic at Suez Canal University Hospitals. Subjects: A Purposive sample of 70 patients admitted in the previous mentioned setting. Tools: four tools were used to collect the study data. Interview questionnaire sheet, adherence scale ,hospital anxiety and depression scale ,Factors affecting adherence to therapeutic regimen. Results: more than half of studied patients had satisfactory level of knowledge. More than half of studied patients had adhered level of adherence to therapeutic regimen. More than half of studied patients' had abnormal level of anxiety,the study revealed that, 74.4% of studied patients' were affect regarding factors, while, 21.6% of studied patients were not affect regarding factors.Conclusion: There was significant  relation between  total adherence  and medical factors. Recommendations: Replication of the study on longer sample to be able generalize the result study.