Objective:To analyse the intermediate-term morbidity and mortality of rheumatic heart disease in patients under the age of 20 years treated with mitral-aortic valve replacement.Methods:A retrospective study was conducted on 55 consecutive patients who underwent mechanical double-valve replacement(DVR) from January

1989 to January

2002.Among the 55 cases

33 were male and 22 female with a mean age of 16.3 years (range 10～20 years).The mean follow up was 4.6 years (maximum 11 years).Results:The operative mortality was 7.3%(4 patients).There was of 2% mortality reported(1 case) in 10 years.At a mean follow-up period of 4.6 years

there was an improvement in functional class from 2.6 to 1.1.There were no increasing incidence of thrombo-embolic and anticoagulant related hemorrhagic events in this study group.Conclusion:The functional results of survivors of DVR performed in the first 2 decades of life are satisfactory.Use of combined warfarin and antiplatelet therapy is appropriate in this age group following DVR (with mechanical valves) for RHD in the aortic-mitral position.