From April, 1982 to December, 1992, multiple valve replacement was performed in 100 patients. Mitral and aortic valve replacement were done in 86 patients, 9 underwent mitral and tricuspid valve replacement, 4 patients underwent triple valve replacement and 1 patient underwent aortic and tricuspid valve replacement. Of the valve implanted, 100 were St. Jude, 64 Duromedics, 19 Carpentier-Edwards, 13 Bj rk-Shiley, 6 Ionescu-Shiley, and 2 Medronics.The hospital mortality rate was 15%[15 patients] and the late mortality rate was 7%[7 patients], the mortality rate was high in early operative period but decreased with time[20% at 1986, 18.2% at 1987, 9.5% at 1988, 11.1% at 1989, 12.5% at 1990, 11.8% at 1991, 0% at 1992]. The causes of death were low cardiac output in 8, sudden death in 3, CHF in 3, bleeding in 2, cerebral thromboembolism in 1, leukemia in 1, multiorgan failure in 1 and so on. The actuarial survival rate excluding operative death was 73% at 10 years.