AbstractIntroduction: Doppler echocardiography was first used for evaluation of prosthetic valve function in 1983 and is a well-established more sensitive noninvasive tool for assessment of prosthetic valve function.6 Even experienced cardiac Sonographers are often uncomfortable with the assessment of artificial heart valves, as the skills acquired for the assessment of native valves do not easily applicable to artificial valves. Methodology: All patients underwent either aortic or Mitral valve replacement or both (DVR) with or without TV repair/TV Annuloplasty through conventional midline sternotomy, during total normothermic cardiopulmonary bypass. Myocardial protection was achieved by intermittent anterograde cold blood cardioplegia. Prosthesis size was selected according to the size of the aortic annulus, & Mitral annulus which was incisures using specific manufacturer’s sizers. Results: Among 114 MVR patients, 38% ATS AP mechanical valve were implanted (n = 44) 18.4% were St. Jude mechanical valve (n = 21) and 17.55% were TTK Chitra disc mechanical valve. Other MVR patient (n = 29) were implanted different types of Tissues valves. (25.4%) Among 44 ATSAP MVR patients, 52% were female (n = 23). Mean age was 37 ± 8.6 years. Conclusion: Mean BSA was 1,59 ± 0.18 m2. Mean EF was 53.5 ± 6.5%. Mean post ATSAP MVR LA size was 3.9 ± 0.63 compare to pre MVR 4.7 ± 0.65.