Six patients with combined valvular disease are descrived. Although the presence of both lesiosn was evident by auscultation, the patients' symptoms and the radiographic and hemodynamic findings were primary those of mitral stenosis. One (case 2) was treated by closed commissurotomy, one (case 4) was closed commissurotomy and tricuspid annuloplasty, one (case 5) open commissurotomy, one (case 3) mitral valve replacement and two (case 1, 6) : had double valve replacement.
One (case 1) died with low cardiac-output syndrome postoperative day and one (case 5) remained class II symptom, but 4 patients was striking symptomatic improvement which has been reflected in the results of postoperative hemodynamic evaluation. The importance of preoperative assessment of patients with combined valvular disease and the choice of the operative method employed in each cases are discussed.
