Prosthetic valve replacement was performed in 113 patients above the age of 60 with advanced valvular heart disease, whose prognosis without surgical correction was extremely poor. Although there was high risk of early mortality in isolated aortic valve disease (20%), in isolated mitral valve disease (28%) and in multiple valve disease (50%), improvement for the survivors was evident. Late mortality was rather low. Individual risk can be estimated by considering the patient's age, type and stage of valvular disease as well as the clinical condition and hemodynamic parameters.