From 1988 to 1992, 16 patients older than 75 years underwent AVR (14 cases) or AVR+MVR (two cases). All patients were followed up for an average of 2.4 years after the operation and follow-up totaled to 38 patient-years. There were no hospital death and one late death. The survival rate was 93.8% through 1 to 5 years and 15 patients are now in NYHA class I or II. The problems of AVR for elderly patients were calcification and small annulus. Decalcification using CUSA was effective technique and supraannular fixing of bioprosthetic valve avoided from aortic annular enlargement. The improved quality of life after AVR supports the aggressive surgery in elderly population.