Twenty-six patients with combined mitral and coronary artery disease were divided into two groups: in group 1, only mitral valve surgery was performed, while in group 2, mitral valve surgery was performed along with coronary artery revascularization. Depressed ventricular function was not a contraindication to surgery; only 2 of 10 patients in group 2 with ejection fractions below 0.4 failed to survive operation. The hospital mortality was similar in both groups, and was higher for mitral valve replacement than mitral valve repair. Follow-up data revealed a higher incidence of late mortality in patients not undergoing revascularization, the main cause of death being myocardial infarction. The addition of revascularization also improved functional capacity.