Emergency mitral and aortic valve replacement during acute rheumatic fever in a 5-year-old child.

Emergency combined mitral and aortic valve replacement was performed during an attack of acute rheumatic fever in a 5-year-old boy. He made an uneventful recovery and has remained asymptomatic 1 year after the operation. From this and other authors' clinical experience, we believe that the decision to operate on these patients should be based on the severity of the disability and the hemodynamic disturbances rather than on the activity or inactivity of the rheumatic process.