Valvular heart disease, regardless of its etiology or chronicity, offers no protection against coronary atherosclerosis. Fifty patients with combined valve and coronary heart disease required aortocoronary bypass grafts in addition to valve reconstruction or replacement. The operative mortality was 8%. Twenty-three of 27 patients for whom follow-up has been more than six months after surgery (average: 14.8 months) are active or have returned to work. Only one patient experiences angina pectoris postoperatively and no myocardial infarctions have occurred in the late period. Eighteen patients underwent a second cardiac catheterization after an average interval of nine months and 24 of 26 grafts (92%) are patent. This review emphasizes the necessity for cinecoronary arteriography in the preoperative evaluation of valvular heart disease.