A 74-year-old woman with non-Marfan syndrome underwent aortic root replacement and mitral valve replacement simultaneously for annulo-aortic ectasia and mitral regurgitation. Postoperatively, she suffered from cholecystitis and underwent percutaneous transhepatic gull bladder drainage. After this intervention, her postoperative recovery was uneventful. The purpose of this study is to suggest the possibility of mitral regurgitation due to annular enlargement of the mitral valve as an outcome of deterioration of the annulo-aortic ectasia.