The clinical results achieved with 91 patients who underwent multiple valve replacement showed that early hospital mortality was 12%. Triple valve replacement was associated with the highest mortality (25%), followed by mitral and tricuspid valve replacement (17%). Late mortality was 11%. Mitral and tricuspid valve replacement had the highest late mortality (29%). Congestive heart failure or low cardiac output was the highest single cause of early and late mortality (nine patients or 9%). Cerebral thromboembolic complications occurred in nine patients; four proved to be fatal. In addition, one patient died of a gastrointestinal tract hemorrhage due to profound hypoprothrombinemia. Long-term results indicated highly satisfactory rehabilitations in over 95% of those patients surviving for follow-up. The long-term results in multiple valve replacement now approach those already seen in single valve replacement.