Objective To describe the level and factors associated with participation in treatment decision-making by patients under-going, and to provide reference for targeted interventions. Methods A total of 171 patients after cardiac valve replacement were investigated by employing the Patients′ Participation in Treatment Decision-making Questionnaire. Results Nearly eighty percent （78.36%） of patients reported low actual participation, 71.93% of them had positive attitude towards participation, 39.18% did not know the type of valve implanted, and 38.60% knew all three items of artificial valve-related knowledge. Logistic regression analysis showed that the level of artificial valve-related knowledge affected participation in treatment decision-making process (P＜0.01). Conclusion Patients undergoing cardiac valve replacement report poor disease knowledge and actual participation in treatment decision-making process, but their attitude toward participation is positive. The level of artificial valve-related knowledge affects their participation, so medical personnel should provide targeted interventions to enhance patient′s disease knowledge in an effort to improve their participation.