Records of 71 consecutive patients who had received multiple valve replacement were reviewed[34male,37female,mean age 40.5$pm$11.2 <14-63> . The early death rate was 2.8%[2/71 . A completed follow-up rate of 95.7% was accomplished in these 69 patients who left hospital[mean 42.5 $pm$29.5 patients-years . Five of these patients died. The late death rate was 7.2%. Four patients experienced anticoagulant-related hemorrhage[all were minor . One patient had a thromboembolic episode[permanent ,and 2 had late prosthetic valve endocarditis. There was no clinical evidence of hemolysis and structural failure of valves used. Of those patients who survived,NYHA functional class improved significantly[from 87.2% class III & IV before to 95.8% class I & II after . Linearized rates for thromboembolism and anticoagulant-related hemorrhage,and for prosthetic valve endocarditis were 0.67%/100 patient-years,2.95%/100 patient-years,1.34%/100 patient-years, respectively. The actuarial estimates of incidence free of all complications and valve-related deaths were 92.2%/patient-years.Despites the advanced heart disease involving two or more native valves, the patients who had multiple valve replacement had very good results, over a 9-year period.