 current techniqu surgic approach aortic mitral valvular diseas 1 aortic mitral valv oper total replac prosthet devic ball-valv type good long-term seventi-four case report 2 aortic valvular diseas outcom postop period influenc presenc calcif aortic stenosi well presenc absenc diseas coronari arteri 3 decreas appear low-output syndrom postop patient suffer sever mitral diseas leav papillari muscl-chorda tendinea-mural leaflet relationship intact feel add strength contract 4 late death follow-up period thirti month patient replac aortic mitral valv ball-valv prosthesi 