The authors report a case of mitro-aortic valvulopathy associated with single-vessel coronary disease, both probably caused by thoracic irradiation, initially for Hodgkin's lymphoma, and later for carcinoma of the breast. The patient was subjected to aortic valve replacement with a mechanical prosthesis, partial mitral annuloplasty and myocardial revascularization. This report underscores the importance of long-term follow up of patients subjected to mediastinal radiotherapy, because of the significant cardiac morbidity caused by this type of treatment.