A retrospective, six-year survey of 72 patients who underwent combined cardiac valve replacement and coronary artery bypass grafting is presented. The average age was 58 years with a male to female ratio of 3.5:1. Eighteen patients were angina-free, their coronary disease being found by routine coronary arteriography. Fifty-eight patients (81%) had aortic valve replacements, 13 patients (18%) had mitral valve replacements, and one patient had a double valve replacement. Forty-one patients (58%) had a single coronary bypass graft. Total cardiopulmonary bypass times averaged two hours, and the average cold myocardial ischaemic time was 60 minutes. The operative mortality in the group was 8%, which did not differ significantly (chi 2 = 0.25; P greater than 0.6) from the operative mortality of 6% in 1400 operations either for single valve replacement or for isolated coronary grafts which were performed in the same six-year period.