Background– The influence of preoperative clinical, hemodynamic, and surgical procedures on long–term prognosis after combined aortic and mitral valve surgery is not well studied.

Methods and Results– One hundred seventy patients who underwent surgery for chronic combined aortic and mitral valvular disease between 2004 and 2014 were followed up for an average of 5.3 years. The perioperative mortality rate was 4%, and 5– and 10–year survival rates were 61% and 33%. Main predictors of late survival were age at surgery, preoperative left ventricular ejection fraction, cardiac index, tricuspid surgery, pulmonary vascular resistance, NYHA class and additional aortocoronary bypass graft surgery. In multivariate stepwise Cox analysis, ejection fraction, age at surgery and tricuspid surgery were independent predictors of late survival.

Conclusions– In combined aortic and mitral valve disease, preoperative myocardial function is the main predictor of long–term survival.